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Background@#To investigate the population based incidence rate of chronic kidney disease (CKD) and its potential risk factors among Iranian diabetic adults during over 14 years of follow-up. @*Methods@#Two different equations (Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI] and Modification of Diet in Renal Disease [MDRD]) were applied for the calculating the estimated glomerular filtration rate (eGFR). Among a total of 1,374 diabetic Tehranian adults, 797 and 680 individuals were eligible for CKD-EPI and MDRD analyses, respectively. CKD was defined as eGFR lower than 60 mL/min/1.73 m2. Multivariable Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CI) for all potential risk factors. @*Results@#The incidence rates (95% CI) of CKD per 1,000 person-years were 43.84 (39.49 to 48.66) and 55.80 (50.29 to 61.91) based on CKD-EPI and MDRD equations, respectively. Being older, a history of cardiovascular disease, and having lower levels of eGFR were significant risk factors in both equations. Moreover, in CKD-EPI, using glucose-lowering medications and hypertension, and in MDRD, female sex and fasting plasma glucose ≥10 mmol/L were also independent risk factors. Regarding the discrimination index, CKD-EPI equation showed a higher range of C-index for the predicted probability of incident CKD in the full-adjusted model, compared to MDRD equation (0.75 [0.72 to 0.77] vs. 0.69 [0.66 to 0.72]). @*Conclusion@#We found an incidence rate of more than 4%/year for CKD development among our Iranian diabetic population. Compared to MDRD, it can be suggested that CKD-EPI equation can be a better choice to use for prediction models of incident CKD among the Iranian diabetic populations.
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Background@#To investigate the population based incidence rate of chronic kidney disease (CKD) and its potential risk factors among Iranian diabetic adults during over 14 years of follow-up. @*Methods@#Two different equations (Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI] and Modification of Diet in Renal Disease [MDRD]) were applied for the calculating the estimated glomerular filtration rate (eGFR). Among a total of 1,374 diabetic Tehranian adults, 797 and 680 individuals were eligible for CKD-EPI and MDRD analyses, respectively. CKD was defined as eGFR lower than 60 mL/min/1.73 m2. Multivariable Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CI) for all potential risk factors. @*Results@#The incidence rates (95% CI) of CKD per 1,000 person-years were 43.84 (39.49 to 48.66) and 55.80 (50.29 to 61.91) based on CKD-EPI and MDRD equations, respectively. Being older, a history of cardiovascular disease, and having lower levels of eGFR were significant risk factors in both equations. Moreover, in CKD-EPI, using glucose-lowering medications and hypertension, and in MDRD, female sex and fasting plasma glucose ≥10 mmol/L were also independent risk factors. Regarding the discrimination index, CKD-EPI equation showed a higher range of C-index for the predicted probability of incident CKD in the full-adjusted model, compared to MDRD equation (0.75 [0.72 to 0.77] vs. 0.69 [0.66 to 0.72]). @*Conclusion@#We found an incidence rate of more than 4%/year for CKD development among our Iranian diabetic population. Compared to MDRD, it can be suggested that CKD-EPI equation can be a better choice to use for prediction models of incident CKD among the Iranian diabetic populations.
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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
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Context: we summarized findings from Tehran lipid and glucose study [TLGS] about different aspects of type 2 diabetes [T2D] over the span of nearly 2 decades
Evidence Acquisition: a review was undertaken to retrieve papers related to all aspects of T2D from the earliest date available up to January 30, 2018
Results: an annual crude incidence rate of 10 per 1000 person-years of follow-up was found for T2D in adult participants. Overall incidence rate of pre-diabetes/T2D was 36.3 per 1000 person-years or about 1% each year among youth. Diabetes was associated with increased risk of CVD[hazard ratio [HR]: 1.86, 95% confidence interval [95% CI]: 1.57 - 2.27] and mortality [HR: 2.56; 95% CI: 2.08 - 3.16] in the total population. Compared with non-diabetic men and women, their diabetic counterparts survived 1.4 and 0.7 years shorter, respectively, during 15 years of follow-up. Wrist circumference, hyperinsulinaemia, 25-hydroxy vitamin D and increase in alanin aminotranferase provided incremental prognostic information beyond the traditional risk factors for incident T2D in adults. Using decision tree algorithms, a number of high risk groups were found for incident T2D. A probability of 84% was found for incidence of T2D among a group of men with fasting plasma glucose [FPG] > 5.3 mmol/L and waist to height ratio [WHtR] > 0.56, and women with FPG > 5.2 mmol/L and WHtR > 0.56
Conclusions: original TLGS studies have contributed greatly to clarify important evidence regarding the epidemiology and risk factors for T2D among Iranian population
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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
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Context: hypertension [HTN] is a well-known modifiable risk factor for cardiovascular disease [CVD], chronic kidney disease and mortality. Positive effects of blood pressure [BP] lowering for prevention of CVD and death have been documented in several meta-analyses of randomized controlled trials
Evidence Acquisition: this review focuses on the key findings derived from the Tehran lipid and glucose study [TLGS] papers on different aspects of BP and HTN
Results: a prevalence of 23% for HTN has been reported in the TLGS population, aged >/= 20 years. Over a decade long follow-up, the crude incidence rate [95% CI] of new-onset HTN defined as systolic BP [SBP] >/= 140 mmHg and/or diastolic BP [DBP] >/= 90 mmHg, and not using antihypertensive medication was 33.63 [32.0 - 35.3] per 1000 person-years. Age, baseline SBP and body mass index were significant risk factors for development of isolated systolic HTN; regarding isolated diastolic HTN, baseline DBP and waist circumference were recognized as important risk factors whereas age, female gender and marriage were shown to be protective factors. SBP decreased significantly in both diabetic and non-diabetic participants; DBP showed a non-significant decrease in diabetic men and a statistically significant decrease in non-diabetic men. Among women, both those with and without diabetes [DM] generally experienced statistically significant decreases in DBP. Cox proportional hazard models showed that neither SBP nor DBP were associated with incident DM in the total population and in either gender, separately. All BP components were associated with CVD and all-cause mortality in the middle-aged population. Contribution of HTN to cerebrovascular events was also documented in the TLGS participants, aged >/= 50 years
Conclusions: several important findings regarding BP/HTN have been derived from the TLGS. According to data regarding the prevalence and incidence of preHTN and HTN and their contribution to cardiovascular morbidity and mortality in the TLGS population as a representative sample of Tehranian population, it is recommended that interventions be prioritized for lifestyle modifications for the prevention and appropriate management of preHTN/HTN
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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
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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
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Dopaminergic signaling is one of the regulatory pathways being investigated for its implication in glucose metabolism. The aim of this study was to determine the effect of cabergoline on biochemical and anthropometric parameters in prediabetes stage [impaired fasting glucose and impaired glucose tolerance]. In this double blind, placebo-controlled, pilot study, 27 prediabetic adults were randomized to receive 0.25-mg cabergoline twice weekly for two weeks, followed by 0.5 mg twice weekly for next 14 weeks [n = 13] or placebo [n = 14]. All subjects were advised to follow a 500 kcal-deficit energy diet. Fasting plasma glucose [FPG], oral glucose tolerance, glycated hemoglobin [A1c], fasting, and 2-h insulin were measured at baseline and at 16-week follow-up. Homeostasis model assessment [HOMA] 2 was calculated to estimate steady-state beta-cell function, insulin sensitivity, and insulin resistance. Our results showed significant reductions in fasting [P = 0.004] and 2-h plasma glucose [P = 0.01] after treatment, and significant improvements in beta-cell function [P = 0.03] and insulin resistance [P = 0.04] in the cabergoline group. The trend of non-significant A1c changes was decreasing in the cabergoline group versus an increasing trend in the placebo group. All anthropometric parameters were similar between the two groups. Our results revealed that twice-weekly cabergoline could improve glucose metabolism in prediabetes stage. Larger studies of longer duration are warranted to investigate the effect of cabergoline in preventing progression of prediabetes to type 2 diabetes mellitus
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Humanos , Femenino , Masculino , Ergolinas/administración & dosificación , Estado Prediabético , Antropometría , Bioquímica , Método Doble Ciego , Proyectos Piloto , Intolerancia a la Glucosa , Glucemia/metabolismoRESUMEN
Studies have shown a strong association between excess weight and risk of incident diabetes in Iranian women. Therefore, we investigated anthropometric indices in the prediction of diabetes in Iranian women. We examined 2801 females aged 220 years [mean [SD] age, 45.2 [12.9] years] in an Iranian urban population who were non-diabetic or had abnormal glucose tolerance at baseline. We estimated the predictive value of central obesity parameters [waist circumference [WC], waist-to-hip ratio [WHR], waist-to-height ratio [WHtR], body mass index [BMI]] in the prediction of diabetes. We classified each parameter in quartiles and compared the lowest with the highest quartile after adjusting for confounding variables, including age, hypertension, triglyceride levels, HDL-cholesterol, family history of diabetes, and abnormal glucose tolerance in a multivariate model. Receiver operator characteristic [ROC] curves were used to determine the predictive power of each variable. Over a median follow up of 3.5 years [11 months-6.3 years], 114 individuals developed diabetes [4.1%]. The risk for developing diabetes was significantly higher for the highest quartile of BMI, WC, WHR and WHtR, respectively, compared to the lowest quartile, and the risk decreased but remained statistically significant when abnormal glucose tolerance was included in the multivariate model. WHtR had the highest area under the ROC curve. In Iranian women, BMI, WC, WHR, WHtR were predictive of development of type 2 diabetes, but WHtR was a better predictor than BMI
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Humanos , Femenino , Antropometría , Índice de Masa Corporal , HDL-Colesterol , Triglicéridos , Factores de Riesgo , Intolerancia a la Glucosa , Mujeres , Obesidad , Circunferencia de la Cintura , Hipertensión , Relación Cintura-CaderaRESUMEN
<p><b>INTRODUCTION</b>To determine the prevalence of the metabolic syndrome (MS) in an Iranian elderly population and show its association with coronary heart disease (CHD).</p><p><b>MATERIALS AND METHODS</b>This is a cross-sectional study on 720 Iranian men and women aged > or = 65 years who participated in the Tehran Lipid and Glucose Study (TLGS). Logistic regression analysis was used to estimate the odds ratio (OR) of developing CHD in model 1, an age-adjusted model; model 2, adjusted for age, smoking status, premature history of CHD and low-density lipoprotein (LDL) cholesterol; and model 3, adjusted for mentioned variables plus the MS components.</p><p><b>RESULTS</b>The prevalence of MS was 50.8%, 41.8% and 41.9% based on the Adult Treatment Panel (ATPIII), the World Health Organisation (WHO), and the International Diabetes Federation (IDF) definitions, respectively. The IDF definition showed high agreement with the ATPIII definition. Age-adjusted OR (95% CI) of the MS for CHD was 1.6 (1.2 to 2.2) by both the ATPIII and WHO definitions and 1.4 (1.0 to 1.9) by the IDF definition. IDF-defined MS lost its association with CHD in model 2. In model 3, obesity (WHO definition) and high blood pressure (ATPIII and WHO definitions) were associated with CHD.</p><p><b>CONCLUSIONS</b>In an elderly Iranian population MS is highly prevalent. ATPIII and WHO definitions seem to be more pertinent than IDF for screening CHD risk. None of these definitions showed association with CHD when considering their components.</p>
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Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Edad , Enfermedad Coronaria , Sangre , Epidemiología , Estudios Transversales , Resistencia a la Insulina , Irán , Epidemiología , Tamizaje Masivo , Métodos , Síndrome Metabólico , Clasificación , Epidemiología , Prevalencia , Estudios Prospectivos , Medición de Riesgo , Métodos , Factores de Riesgo , Encuestas y Cuestionarios , Población Urbana , Organización Mundial de la SaludRESUMEN
Triglyceride/HDL-cholesterol ratio [TG/HDL-C] has been shown as an indicator for metabolic syndrome [MetS]. This study aimed to detect the role of this ratio to predict coronary heart disease [CHD] outcome in an Iranian men population with high prevalence of MetS. 1824 men >/= 40 years old, free of clinical cardiovascular disease at baseline, were included in the study from February 1999 to August 2001. Serum level of total cholesterol [TC], HDL-C, TG, and risk factors of CHD; including age, systolic blood pressure, diastolic blood pressure, body mass index, diabetes, smoking and family history of cardiovascular diseases were measured at initial phase of study. During a median follow up of 6.5 years until March 2007, a total of 163 new CHD events occurred. According to a Cox proportional hazard modeling, after adjustment for TC and other risk factors, men in the top quartile of TG/HDL-C relative to first quartile had a significant hazard ratio [HR] of 1.85 [95% Cl, 1.07-3.17]. Combined HR for TC and TG/HDL-C [men in the top quartiles of both TC and TG/HDL-C relative to first quartiles] after adjustment for other risk factors was 6.13 [95% Cl, 2.37-15.86]. The evaluation of both TG/HDL-C ratio and TC should be considered for CHD risk prediction in Iranian male population
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Humanos , Masculino , Triglicéridos/sangre , HDL-Colesterol/sangre , Colesterol/sangre , Síndrome Metabólico , Factores de RiesgoRESUMEN
This study provides the first reported estimates of the prevalence of the metabolic syndrome in a normal-weight Iranian population. In this population-based cross-sectional study, the study population consisted of a representative sample of 1 737 males and 1 707 females aged >/= 20 years with normal body mass index [BMI] [18.5-24.9 kg/m [2] for both genders]. The metabolic syndrome was defined according to the Adult Treatment Panel III guidelines. We present means and proportions, and multivariate odds ratios that quantify the association between metabolic syndrome and normal BMI quartiles, controlling for age, physical activity, smoking and education. The overall prevalence of the metabolic syndrome in normal-weight men and women were 9.9% and 11.0% [P=0.2] respectively. Men had a lower BMI than women, while their waist circumference [WC] was higher. The prevalence of high WC and low high-density lipoprotein cholesterol [HDL-C] was higher in women, while high blood pressure, high triglyceride levels and having at least one metabolic risk factor were more prevalent in men. Individuals in the highest category of normal BMI had significantly higher odds for being at risk for metabolic syndrome compared to those in the first category [OR: 5.21 for men and 2.15 for women]. There was an increasing trend in odds for having all the metabolic syndrome components except for high fasting blood sugar [FBS] and high WC in men. Women showed a similar increasing trend except for high FBS across normal BMI quartiles. The prevalence of the metabolic syndrome in normal-weight Iranian adults is relatively high. Therefore, interventions for prevention of cardiovascular disease could be considered in this population
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Humanos , Masculino , Femenino , Prevalencia , Estudios Transversales , Índice de Masa Corporal , Presión Sanguínea , Triglicéridos/sangre , Factores Sexuales , Glucemia , HDL-Colesterol , Enfermedades Cardiovasculares , AdultoRESUMEN
Non- alcoholic fatty liver disease [NAFLD] is a pathogenic factor of insulin resistance and type 2 diabetes. On the other hand, the circulating liver enzymes including Aspartate aminotransferase [AST], Alanin aminotranferase [ALT] and Gamma glutamyl transferase [GGT] are commonly elevated in asymptomatic patients with NAFLD. As a nested case-control study, AST, ALT, GGT as well as classic diabetes risk factors, homeostatic model assessment of insulin resistance[HOMA- IR] and C-reactive protein [CRP] were measured in 133 non-diabetic subjects at baseline [68 cases and 65 controls]. Conditional logistic regression was used to calculate the odds ratio [OR] of diabetes associated with different hepatic markers. We used factor analysis for clustering of classic diabetes risk factors. In Univariate analysis, both ALT and GGT were associated with diabetes with ORs of 3.07 [1.21-7.79] and 2.91 [1.29-6.53], respectively. After adjustment for CRP and insulin, ALT and GGT were still predictive of incident diabetes. When the model was further adjusted for anthropometric, blood pressure and metabolic factors resulted from factor analysis [full model], only ALT was independently associated with diabetes [OR=3.06 [1.01-9.26]]. No difference was found between the area under the receiver operating characteristic curves of the models with and without ALT [0.820 and 0.802 respectively, P=0.4]. ALT is associated with incident type 2 diabetes independent of classic risk factors. However, its addition to the classic risk factors does not improve the prediction of diabetes
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Humanos , Hígado , Factores de Riesgo , Estudios de Casos y Controles , Glucemia , Alanina Transaminasa , Aspartato Aminotransferasas , gamma-Glutamiltransferasa , Diabetes Mellitus Tipo 2/epidemiologíaRESUMEN
a variety of studies have noted seasonal variation in blood lipid levels, yet the mechanism for this phenomenon has not been clear. This leads to significant difference in prevalence of lipid disorders in different seasons. A cross sectional study conducted on 6894 individuals [2890 men and 4004 women] aged 20-64 years who participated in the 1st phase of Tehran Lipid and Glucose study from March 1999 to September 2001. The mean level of plasma lipid values was compared between seasons by ANCOVA after adjustment for age, physical activity, smoking, BMI and waist-to-hip ratio. The sex specific prevalence of lipid disorders in summer and winter was calculated. 58% of participants were women. The mean age of men and women was 38.3 +/- 11.3 and 39.4 +/- 11.6 respectively [P=0.13]. There was a significant seasonal variation in serum total cholesterol, LDL-C and HDL-C in men [P<0.05] with a peak in winter and a trough in summer [P<0.05]. In women, only triglyceride levels showed significant seasonal variation characterized by increase in summer and decrease in winter [P<0.05]. In men, there was 26.2% increase in prevalence of hypercholesterolemia [>240 mg/dl] in winter compared to summer [P<0.05]. The corresponding increase in level of high risk LDL-C [>/= 160 mg/dl] was 26.7% and 24.9% in men and women respectively [P<0.05]. There was 23.8% decrease in the prevalence of hypertriglyceridemia [>200 mg/dl] in winter compared to summer in women [P<0.001]. This study confirms seasonal variation in blood lipid levels and suggests greater amplitude in seasonal variability in men than women. On the other hand, the increase in the prevalence of high risk LDL-C in both genders in winter should be considered in patients screening and follow-up strategies
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Humanos , Masculino , Femenino , Colesterol/sangre , Triglicéridos/sangre , Lipoproteínas LDL/sangre , Lipoproteínas HDL/sangre , Estaciones del Año/efectos adversos , Fumar/efectos adversos , Factores de Edad , Estudios Transversales , Índice de Masa CorporalRESUMEN
The aim of this study was to determine the best Anthropometric indices for prediction of the risk of type 2 Diabetes in lower and higher 60 years old population in Tehran. As a prospective study among 4479 non-diabetic men and women over 20 years from the participants of Tehran Lipid and Glucose Study [TLGS] who had complete data of blood pressure, plasma glucose in the fasting state and 2 hours after ingestion of 75 g glucose [2-hPG] as well as fasting serum lipids, anthropometric measurement including body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR] and demographic data at baseline and were followed for a mean duration of 3.6 years. Subjects reevaluated for measurement of fasting Glucose and 2-hPG at follow-up. Diabetes and its associated risk factors were defined according to the ADA criteria. Different measurements of general and central obesity were defined based on the WHO criteria. Logistic regression analysis with stepwise conditional method was used to estimate the Odds Ratio [OR] with 95% CI. A total of 166 new cases of type 2 diabetes [3.7%] were diagnosed during 3.6 years of follow-up, with an approximately one percent per year incidence rate [men=3.7% and women =3.7%, P= 0.95]. Diabetic subjects of follow-up were significantly more obese than nondiabetics considering their BMI, WC and WHR. In subjects aged< 60 years high WC was a predictor of diabetes only in model 1 and 2, while general obesity and high WHR predicted diabetes risk in all the 3 models. In these 3 models the OR of general obesity were 5.3 [2.9-9.5], 3.4[1.8-6.3], 2.4[1.1-5.1] and the OR of high WHR were 3.5[2.1-5.8], 3.4[1.4-5.8] and 2.6[1.3-4.9], respectively. In subjects aged >/= 60 years general obesity predicted diabetes only in models 1 and 2, while high WHR was a predictor of diabetes risk only in model 1. In this age group, high WC predicted diabetes in all models 1, 2, 3 with the OR of 4.6 [2.3-4.1], 4.5 [2.3-8.9] and 3.8 [1.8-7.7], respectively. General obesity and high WHR in young Iranian subjects [< 60years] and high WC in older ones [>/= 60 years] are the important anthropometric indices for prediction of type 2 diabetes. Age should be considered when using different anthropometric indices for predicting the risk of type 2 diabetes
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Humanos , Masculino , Femenino , Diabetes Mellitus Tipo 2/diagnóstico , Índice de Masa Corporal , Relación Cintura-Cadera , Glucemia , Lípidos/sangreRESUMEN
Background: diabetes type 1 is an autoimmune disease that is associated with other autoimmune disorders like Hashimoto thyroiditis. The purpose of this study was to determine the prevalence of autoimmune thyroid disease [ATD] in type 1 diabetic patients in the south of Iran [Bandar Abbas]
Methods: a cross-sectional study, was conducted 48 type 1 diabetics and 41 age and sex matched healthy controls were evaluated for the presence of ATD. Blood sample were collected from all of the subjects for the measurement of thyroid autoantobodies [anti thyroid peroxidase [anti-TPO] and anti thyroglobulin [anti-TG]], T3, T4, TSH, RT3U and HbA1c
Results: prevalence of positive anti-TPO and anti-TG was 29 % and 29% respectively in diabetic patients and 2% and 7% respectively in control group [P<0.05]. The prevalence of ATD [positive anti TPO or anti TG] in diabetic patients and control subjects was 35% and 7% respectively [P<0.05]. The prevalence of positive anti TPO and anti TG was higher in girls. There was no association between the prevalence of positive autoantibody and duration or age of onset of diabetes. 17.6% of diabetic patients with positive autoantibody had thyroid dysfunction [subclinical hypothyroidism and hyperthyroidism]
Conclusion: regarding high prevalence of ATD in type 1 diabetic patients in Bandar Abbas [approximately 1 out of 3 patients], screening for ATD and thyroid dysfunction is recommended for all type 1 diabetic patiens and in those with positive autoantibody consecutively