ABSTRACT
Context: dyslipidemia, including elevated serum total cholesterol [TC], low density lipoprotein cholesterol [LDL-C], and triglycerides [TG], and low high density lipoprotein cholesterol [HDL-C] is a major modifiable risk factor for non-communicable diseases [NCDs]. This review summarizes many of the key findings on lipid measures in the Tehran lipid and glucose study [TLGS], a large scale community-based study with an approximately two decade follow-up
Evidence Acquisition: a systematic literature search was conducted using PubMed, Scopus, Web of Science databases, and the library of the Research Institute for Endocrine Sciences, using the following keywords: Lipid measures, lipid ratios, lipid profile, dyslipidemia, and "Tehran lipid and glucose study". Articles were categorized based on fields of prevalence, trends, and impact of lipid profile on incident NCDs and mortality
Results: Between 1999 - 2001, the prevalence of high risk lipids ranged from 14% [low HDL-C] to 17% [high LDL-C] among adolescents, although among adults the lowest and highest prevalence were observed for low HDL-C [19%] and high TG [28%]. Despite favorable trends for lipid parameters among adolescents, adults, and the elderly population, a considerable number of diabetic individuals, failed to achieve the optimum level of serum lipids. During follow-up, consumption of lipid lowering drugs increased from 1.5 to 9.0% and 3.7 to 11.4% among adult men and women, respectively. The association between different lipid parameters and related ratios for incident type 2 diabetes [T2D], hypertension, metabolic syndrome and cardiovascular diseases differed between genders. Interestingly, each 1-unit increase in TC/HDL-C increased risk of hypertension among women [odds ratio [OR]: 1.19, 95% confidence interval [CI]: 1.00 - 1.27] and T2D among men [OR: 1.27, 95% CI: 1.06 - 1.51]. Moreover, TC, LDL-C, non-HDL-C, Ln-TG, TC/HDL-C, and Ln- TG/HDL were inversely associated with non-cardiovascular mortality
Conclusions: despite high prevalence of high risk lipid profiles among the TLGS population at baseline, favorable trends were observed in levels of all lipid components, which might be attributable to increased consumption of lipid-lowering medications and improvement in the general knowledge of Iranians regarding limited consumption of hydrogenated oil. Considering the impact of lipid profiles on incident NCDs, more attention should be paid to at-risk groups for screening and treatment purposes
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
ABSTRACT
Background: several studies have emphasized the importance of cardiovascular disease [CVD] prevention. However, there is a dearth of data on the prevention of cardiovascular disease recurrence. The present study was the 1st in Iran to evaluate factors associated with CVD recurrence
Methods: this prospective cohort study was conducted on 483 subjects [> 30 years old] with a history of CVD who participated in the Tehran Lipid and Glucose Study and were followed up for 12 years [1999-2012]. The relationships between the most important established risk factors for CVD and CVD recurrence were evaluated
Results: totally, 258 [53.4%] men and 225[46.5%] women at a mean age of 59.2 +/- 10.7 years were recruited in the study. Our results showed that over the 12-year follow-up, the incidence of a recurrent event [per 100 person-years] was 48.5. Further, after controlling the possible confounding factors, the following variables had a significant relationship with CVD recurrence: age [HR = 1.02; p value = 0. 001], male sex [HR = 1.4; p value = 0.012], smoking [HR = 1.7; p value = 0.004], and increased fasting blood sugar [HR = 2.1; p value = 0.001]
Conclusion: we found that the established variables in the development of CVD [i.e., age, sex, and smoking] played an important role in the risk of CVD recurrence
ABSTRACT
Helicobacter Pylori [H.pylori] is one of the most important causes of dyspepsia and diagnosis can be made by invasive or non-invasive methods. One of the non-invasive methods, H.pylori stool antigen test [HpSA] is simple, fast and relatively inexpensive. According to this view with regard to gastric biopsy as a gold standard the sensitivity, specificity, positive and negative predictive values of this method were calculated. Stool samples of 61 patients who underwent upper endoscopy and gastric biopsy due to dyspepsia were evaluated for H. Pylori stool antigen using sandwich ELISA method. From the 61 patients who participated in this study, H.pylori was diagnosed in 38 [62.3%] gastric biopsies, 25[66%] of these had positive HpSA test. Also, of 27 [37.7%] positive HpSA cases, H.pylori was seen in 25 gastric biopsies. For this method, sensitivity of 66% with 93% positive predictive value was calculated. Also, 91% specificity with 62% negative predictive value was estimated. High positive HpSA indicates high risk of H.pylori infection and high specificity shows that the likelihood of false positive is low. Therefore, physicians can trust on this method and start patient`s treatment