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Pourfarzi F, Rezaei S, Zahirian Moghadam T, Zandian H, Dibazar F. The socio-economic inequality in body mass index: a PERSIAN cohort-based cross-sectional study on 20,000 Iranian adults. BMC Endocr Disord 2022; 22:178. [PMID: 35840953 PMCID: PMC9287943 DOI: 10.1186/s12902-022-01096-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 07/11/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION The aim of the present study was to explore and determine the association between BMI and socio-economic factors in Iran. METHODS Adults aged 35 to 70 (n = 20,460) were included from Ardabil Non-Communicable Disease (ArNCD) cohort study. BMI was calculated as kg/m2. Principal Component Analysis (PCA) was used to determine the socio-economic quintiles. Multivariate linear regression was performed to analyze the association of BMI as dependent variable with explanatory variables, Additionally, decomposition analyzing conducted to identify factors that explained wealth-related inequality in obesity. RESULTS The prevalence of overweight and obese people was 83.7% (41.4% overweight and 42.5% obese) wherein the highest frequency of obese people belonged to the age group of 45 to 49 years old (19.9%) and to the illiterate people (33.1%). The results of multivariate linear regression model showed that age, being female, marriage, lower education level, having chronic disease, alcohol use, and higher socioeconomic level positively associated with obesity. The results of the decomposition model showed that the most important variables affecting socioeconomic inequality in higher BMI level were socioeconomic status (75.8%), being women (5.6%), education level (- 4.1%), and having chronic disease (2.4%). CONCLUSION BMI showed significant association with socio-economic status, where richest people had significantly higher BMI than poorest group. Considering the direct role of high BMI in non-communicable diseases, new policies are needed to be developed and implemented by means of diet intervention and increased physical activity to control the BMI in the population of Iran.
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Affiliation(s)
- Farhad Pourfarzi
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Satar Rezaei
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Telma Zahirian Moghadam
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Foad Dibazar
- Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
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Golestani M, Sadeghi-Bazargani H, Saadati M, Farahbakhsh M, Dalal K. Lifestyle Risk Factor Assessment Through WHO STEP Approach in Tabriz, Iran. CLINICOECONOMICS AND OUTCOMES RESEARCH 2021; 13:487-492. [PMID: 34140788 PMCID: PMC8203186 DOI: 10.2147/ceor.s304189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/10/2021] [Indexed: 11/23/2022] Open
Abstract
Background The aim of this study was to assess the lifestyle behaviour and risk factors for lifestyle-related diseases in East Azerbaijan province, Iran. Methods A household study using a two-stage cluster sampling method was performed. Tabriz city was randomly selected for data collection among five geographic regions in the East-Azerbaijan province. Short WHO-STEP and Ultra-short version of Socio-Economic Status assessment questionnaire were used. Six hundred households were asked to respond to the STEP questionnaire. Results A total of 1196 people have participated in the study. People with higher socioeconomic status consumed more fruits, vegetables and fish than the people with lower socioeconomic status. People with academic education less likely to be hypertensive compared to people with non-academic education. People with a medium socioeconomic status are less likely to be hypertensive than people with high socioeconomic status. The majority of participants had poor dietary habits. In this study, 17.22%, 7.53% and 4.35% of respondents had hypertension, diabetes and depression, respectively. Conclusion Considering that lifestyle-related risk factors are common among people. Due to the direct link between lifestyle and the occurrence of many chronic diseases, campaigns for and training programs to implement healthy lifestyle habits are recommended.
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Affiliation(s)
- Mina Golestani
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Homayoun Sadeghi-Bazargani
- Road Traffic Injury Research Center, Statistics and Epidemiology Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Saadati
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mostafa Farahbakhsh
- Clinical Psychiatry Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Koustuv Dalal
- Department of Public Health Science, School of Health Sciences, Mid Sweden University, Sundsvall, Sweden.,School of Medicine and Health Care, Al-Farabi Kazakh National University, Almaty, Kazakhstan
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Jamalizadeh A, Kamiab Z, Esmaeili Nadimi A, Nejadghaderi M, Saeidi A, Porkarami A. Prevalence of smoking and high blood pressure, two major risk factors for non-communicable diseases: the SuRF NCD (surveillance of risk factors of non-communicable disease) report 2012. J Cardiovasc Thorac Res 2016; 8:183-187. [PMID: 28210475 PMCID: PMC5304102 DOI: 10.15171/jcvtr.2016.36] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 11/04/2016] [Indexed: 11/23/2022] Open
Abstract
Introduction: In recent years non-communicable diseases (NCDs) risk factors such as tobacco consumption and high blood pressure (BP) have been increased. This study aimed to determine the frequency of risk factors of the main NCDs among inhabitants of Rafsanjan city.
Methods: Our study is a part of NCD surveillance in Iran (SuRF NCD). A total of 640 people enrolled and divided in four age groups in urban and rural areas in Rafsanjan (a city in Kerman province). Data were collected using the standardized stepwise protocol for NCD risk factor surveillance of the World Health Organization (WHO). This study focused on hypertension (HTN) and smoking.
Results: A total of 640 people (46.9% male and 53.1% female) participated in this cross-sectional study. The prevalence of HTN was 198 per 1000 population. 4.8% of those were below the age of 44, and 15% between 45 and 70 years old. Mean systolic BP was 127 ± 15.6 in male and 118 ± 19.65 in female and the statistical difference was significant (t = 5.55, P < 0.001). 79 (14.1%) of hypertensive live in urban and 32 (5.7%) live in rural areas (χ2 = 8.004, P = 0.005). The prevalence of current smokers was 112 per 1000 population; among them 56 (88.9%) were daily smokers. The mean age for starting smoking was 21.11 ± 7.16 years.
Conclusion: Modifying risk factors such as HTN and smoking behavior through primary and secondary prevention programs by enhancing awareness and knowledge of lay people, improvement screening and treatment interventions, particularly for the youth is highly recommended.
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Affiliation(s)
- Ahmad Jamalizadeh
- Department of Health, Rafsanjan University of Medical Science, Rafsanjan, Iran
| | - Zahra Kamiab
- Head of the Clinical Research Development Center, Department of Community Medicine, Rafsanjan University of Medical Science, Rafsanjan, Iran
| | - Ali Esmaeili Nadimi
- Department of Cardiology, Rafsanjan University of Medical Science, Rafsanjan, Iran
| | | | - Ala Saeidi
- Health Department, Rafsanjan University of Medical Science, Rafsanjan, Iran
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Peykari N, Saeedi MS, Djalalinia S, Kasaeian A, Sheidaei A, Mansouri A, Mohammadi Y, Parsaeian M, Mehdipour P, Larijani B, Farzadfar F. High Fasting Plasma Glucose Mortality Effect: A Comparative Risk Assessment in 25-64 Years Old Iranian Population. Int J Prev Med 2016; 7:75. [PMID: 27280011 PMCID: PMC4882967 DOI: 10.4103/2008-7802.182732] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 02/07/2016] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND High fasting plasma glucose (FPG) is one of the main leading risk factors of ischemic heart disease (IHD), stroke, and chronic kidney diseases (CKDs). We estimated population attributable fraction (PAF) and attributed death of these fatal outcomes of high FPG at national and subnational levels in 25-64 years old Iranian adult. METHODS We used national and subnational data of the Non-Communicable Disease Surveillance Survey for exposure to risk factors in 2005 and 2011 among Iranian adults of 25-64 years old. For estimating the attributed death, using the death registration system data of Iran, we multiply the cause-specific PAFs by the number of outcome-specific deaths. RESULTS In Iran, high FPG was responsible for about 31% of attributed total deaths of IHD, stroke, and CKD in 2011. The related attributed deaths had increased from 2005 to 2011. In females, the PAFs for the effect of high FPG on IHD, stroke, and CKD were higher in 2011 than 2005 in all age groups. In males, this increase has occurred in over 45 years old. The highest PAFs of high FPG outcomes mostly related to central provinces of Iran. The central region of Iran had the highest and the southeast of the country had the lowest levels of attributed deaths. CONCLUSIONS Considering the global 25 × 25 targets for noncommunicable disease mortality reduction, high FPG as a leading risk factor of fatal outcomes should be more targeted through the dietary, behavioral, and pharmacological interventions in Iran.
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Affiliation(s)
- Niloofar Peykari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Moghaddam Sahar Saeedi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Amir Kasaeian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anita Mansouri
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Younes Mohammadi
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahboubeh Parsaeian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Parinaz Mehdipour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Tabrizi JS, Farahbakhsh M, Sadeghi-Bazargani H, Hassanzadeh R, Zakeri A, Abedi L. Effectiveness of the Health Complex Model in Iranian primary health care reform: the study protocol. Patient Prefer Adherence 2016; 10:2063-2072. [PMID: 27784996 PMCID: PMC5063286 DOI: 10.2147/ppa.s107785] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Iranian traditional primary health care (PHC) system, although proven to be successful in some areas in rural populations, suffers major pitfalls in providing PHC services in urban areas especially the slum urban areas. The new government of Iran announced a health reform movement including the health reform in PHC system of Iran. The Health Complex Model (HCM) was chosen as the preferred health reform model for this purpose. METHODS This paper aims to report a detailed research protocol for the assessment of the effectiveness of the HCM in Iran. An adaptive controlled design is being used in this research. The study is planned to measure multiple endpoints at the baseline and 2 years after the intervention. The assessments will be done both in a population covered by the HCM, as intervention area, and in control populations covered by the traditional health care system as the control area. DISCUSSION Assessing the effectiveness of the HCM, as the Iranian PHC reform initiative, could help health system policy makers for future decisions on its continuation or modification.
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Affiliation(s)
- Jafar Sadegh Tabrizi
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mostafa Farahbakhsh
- Research Center of Psychiatry & Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Homayoun Sadeghi-Bazargani
- Road Traffic Injury Research Center, Department of Statistics & Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
- WHO Collaborating Center on Community Safety Promotion, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
- Correspondence: Homayoun Sadeghi-Bazargani, Road Traffic Injury Research Center, Department of Statistics & Epidemiology, Tabriz University of Medical Sciences, Sadeghi Street, Golshahr Square, El Goli Avenue, Tabriz 5167846311, Iran, Tel +98 9144027218, Email
| | - Roya Hassanzadeh
- Department of Health Services Management, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics
| | - Akram Zakeri
- National Public Health Management Center, Tabriz University of Medical Sciences, Tabriz
| | - Leili Abedi
- Department of Statistics and Epidemiology, Faculty of Health, Kerman University of Medical Sciences, Kerman, Iran
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Ahmadi A, Soori H, Mehrabi Y, Etemad K, Sajjadi H, Sadeghi M. Predictive Factors of Hospital Mortality Due to Myocardial Infarction: A Multilevel Analysis of Iran's National Data. Int J Prev Med 2015; 6:112. [PMID: 26730342 PMCID: PMC4689097 DOI: 10.4103/2008-7802.170026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 07/13/2015] [Indexed: 01/10/2023] Open
Abstract
Background: Regarding failure to establish the statistical presuppositions for analysis of the data by conventional approaches, hierarchical structure of the data as well as the effect of higher-level variables, this study was conducted to determine the factors independently associated with hospital mortality due to myocardial infarction (MI) in Iran using a multilevel analysis. Methods: This study was a national, hospital-based, and cross-sectional study. In this study, the data of 20750 new MI patients between April, 2012 and March, 2013 in Iran were used. The hospital mortality due to MI was considered as the dependent variable. The demographic data, clinical and behavioral risk factors at the individual level and environmental data were gathered. Multilevel logistic regression models with Stata software were used to analyze the data. Results: Within 1-year of study, the frequency (%) of hospital mortality within 30 days of admission was derived 2511 (12.1%) patients. The adjusted odds ratio (OR) of mortality with (95% confidence interval [CI]) was derived 2.07 (95% CI: 1.5–2.8) for right bundle branch block, 1.5 (95% CI: 1.3–1.7) for ST-segment elevation MI, 1.3 (95% CI: 1.1–1.4) for female gender, and 1.2 (95% CI: 1.1–1.3) for humidity, all of which were considered as risk factors of mortality. But, OR of mortality was 0.7 for precipitation (95% CI: 0.7–0.8) and 0.5 for angioplasty (95% CI: 0.4–0.6) were considered as protective factors of mortality. Conclusions: Individual risk factors had independent effects on the hospital mortality due to MI. Variables in the province level had no significant effect on the outcome of MI. Increasing access and quality to treatment could reduce the mortality due to MI.
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Affiliation(s)
- Ali Ahmadi
- Department of Epidemiology and Biostatistics, Research Center for Modeling of Non Communicable Disease, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Hamid Soori
- Department of Epidemiology, Safety Promotion and Injury Prevention Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yadollah Mehrabi
- Department of Epidemiology, Safety Promotion and Injury Prevention Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Koorosh Etemad
- Department of Epidemiology, Safety Promotion and Injury Prevention Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Homeira Sajjadi
- Department of Community Medicine, Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
| | - Mehraban Sadeghi
- Department of Environmental Health Engineering, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Sharifi-Zahabi E, Entezari MH, Maracy MR. Effects of Soy Flour Fortified Bread Consumption on Cardiovascular Risk Factors According to APOE Genotypes in Overweight and Obese Adult Women: A Cross-over Randomized Controlled Clinical Trial. Clin Nutr Res 2015; 4:225-34. [PMID: 26566517 PMCID: PMC4641984 DOI: 10.7762/cnr.2015.4.4.225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 09/29/2015] [Accepted: 10/03/2015] [Indexed: 12/19/2022] Open
Abstract
Recent studies suggest that inclusion of soy product in the diet may have favorable effects on relief of cardiovascular diseases (CVDs) and risk factors. These effects might be associated with the presence of specific polymorphism in gene. The aim of this study was to examine the effects of consumption of soy flour fortified bread on cardiovascular risk factors in overweight and obese women according to APOE genotype. In a randomized cross-over clinical trial 30 overweight and obese women received a mild weight loss diet and assigned to a regular diet and a soy bread diet, each for 6 weeks and a washout period for 20 days. Subjects in the soy bread diet were asked to replace 120 grams of their daily usual bread intake with equal amount of soy bread. No significant effects of soy bread on serum lipid, systolic blood pressure and anthropometric indices were observed compared to the regular diet (p > 0.05). For diastolic blood pressure (DBP), comparison of mean differences between two groups showed a marginally significant effect of soy bread (p = 0.06). Compared to regular diet, soy bread had a significant effect on DBP in E2 genotype group (ε2/ε2) (p = 0.03). Having ε2 allele may influences responses of CVD risk factor to soy bread consumption. However more nutrigenetic studies are required.
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Affiliation(s)
- Elham Sharifi-Zahabi
- Food Security Research Center and Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Mohammad H Entezari
- Food Security Research Center and Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Mohammad R Maracy
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
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Jafari-Adli S, Jouyandeh Z, Qorbani M, Soroush A, Larijani B, Hasani-Ranjbar S. Prevalence of obesity and overweight in adults and children in Iran; a systematic review. J Diabetes Metab Disord 2014; 13:121. [PMID: 25610814 PMCID: PMC4301060 DOI: 10.1186/s40200-014-0121-2] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Accepted: 12/06/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Obesity is one of the most important underlying risk factors for chronic disease. Dramatically increasing and following complication of obesity should be alerted to health politicians and practitioners to prevent associated health risks. This review aimed to give a better insight into the prevalence of obesity and overweight in different areas of Iran. METHOD All published internal (SID, Irandoc, Iranmedex), and international (Web of Knowledge, Pubmed, Scopus) source studies, reported the prevalence of overweight/obesity among normal population samples, during Jan 2005 through Jan 2014, were assessed in this review. Paper selection processes were done by two researchers separately. Studies which met the eligible criteria were included in this review. RESULT One hundred ninety three eligible studies enter into our review. Of 193 final selected studies, 86 (15 national, 71 sub national) of them were reported the prevalence of obesity/overweight in adult, and 107 studies (11 national, 96 sub national) in under-18 by individual. The range of overweight and obesity prevalence in national studies in adult, was 27.0-38.5 (95% CI: 26.8-27.1, 37.2-39.8), and 12.6-25.9 (95% CI: 12.2-13.0, 24.9-26.8), separately. In under-18 the range of overweight and obesity prevalence in national studies were 5.0-13.5 (95% CI: 4.5-5.5, 13.4-13.6), and 3.2-11.9 (95% CI: 3.0-3.4, 11.3-12.4). CONCLUSION Obesity as an important public health problem has been discussed in recent few decades worldwide. Although the national reported prevalence of obesity in Iran was not considerably diverse, but remarkable differences were seen in the sub national prevalence which must be noticed more in political health programs especially among women and children.
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Affiliation(s)
- Shahrzad Jafari-Adli
- />Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Jouyandeh
- />Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- />Department of Community Medicine, Alborz University of Medical Sciences, Karaj, Iran
- />Non communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Soroush
- />Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- />Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, 5th floor of Shariati Hospital, North Karegar St., P.O Box 1411413137, Tehran, Iran
| | - Shirin Hasani-Ranjbar
- />Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- />Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, 5th floor of Shariati Hospital, North Karegar St., P.O Box 1411413137, Tehran, Iran
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Sadjadi A, Yazdanbod A, Lee YY, Boreiri M, Samadi F, Alizadeh BZ, Islami F, Fyfe V, Babaei M, Namazi MJ, Going JJ, Sotoudeh M, de Bock GH, Malekzadeh R, Derakhshan MH. Serum ghrelin; a new surrogate marker of gastric mucosal alterations in upper gastrointestinal carcinogenesis. PLoS One 2013; 8:e74440. [PMID: 24098650 PMCID: PMC3787044 DOI: 10.1371/journal.pone.0074440] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 08/02/2013] [Indexed: 01/24/2023] Open
Abstract
Background A few studies have indicated inverse relationships between serum ghrelin and gastric and esophageal cancers but those associations have been restricted to specific populations, including smokers and overweight individuals. We examined the association between ghrelin and gastroesophageal cancers and atrophic gastritis in a population-based setting. Methods In total 220 gastroesophageal cancers, comprising non-cardia and cardia gastric cancer, esophageal adenocarcinoma, esophageal squamous cell carcinoma (SCC) and age and gender-matched controls were recruited. Serum ghrelin, pepsinogen I/II ratio (PGI/II) and anti-H.pylori IgG antibodies were measured. Relationships between ghrelin and gastroesophageal cancers, after adjustment for PGI/II ratio, H.pylori status and smoking, were tested using logistic regression. Furthermore, in 125 endoscopically normal volunteers, with and without histological atrophic gastritis, the relationship with ghrelin was compared. Results Serum ghrelin (lowest vs. highest quintile) was inversely associated with gastric cancer: OR (95% CI) 8.71 (1.70–44.59) for cardia and 6.58 (1.26–34.46) for non-cardia cancer. Lower serum ghrelin was also associated with esophageal SCC: OR (95% CI) 5.69 (1.36–23.78), but not with esophageal adenocarcinoma. A similar association was observed between gastric cancer (cardia and non-cardia) and esophageal SCC when serum ghrelin was analysed as a continuous scaled variable. In endoscopically-normal volunteers, extensive atrophic gastritis was associated with low serum ghrelin [OR (95% CI) 0.25 (0.10–0.64)]. Conclusion Inverse associations between ghrelin and some gastroesophageal cancers suggest a potential role for serum ghrelin as a biomarker of upper gastrointestinal cancers and atrophic gastritis. In areas with a high incidence of gastric and/or esophageal cancer, screening might be more effectively targeted to individuals with low serum ghrelin in addition to the PGI/II ratio.
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Affiliation(s)
- Alireza Sadjadi
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran ; Department of Epidemiology, University of Groningen, University Medical Center Groningn, Groningen, The Netherlands
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Sadjadi A, Derakhshan MH, Yazdanbod A, Boreiri M, Parsaeian M, Babaei M, Alimohammadian M, Samadi F, Etemadi A, Pourfarzi F, Ahmadi E, Delavari A, Islami F, Farzadfar F, Sotoudeh M, Nikmanesh A, Alizadeh BZ, de Bock GH, Malekzadeh R. Neglected role of hookah and opium in gastric carcinogenesis: a cohort study on risk factors and attributable fractions. Int J Cancer 2013; 134:181-8. [PMID: 23797606 DOI: 10.1002/ijc.28344] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 05/30/2013] [Accepted: 06/03/2013] [Indexed: 01/01/2023]
Abstract
A recent study showed an association between hookah/opium use and gastric cancer but no study has investigated the relationship with gastric precancerous lesions. We examined the association between hookah/opium and gastric precancerous lesions and subsequent gastric cancer. In a population-based cohort study, 928 randomly selected, healthy, Helicobacter pylori-infected subjects in Ardabil Province, Iran, were followed for 10 years. The association between baseline precancerous lesions and lifestyle risk factors (including hookah/opium) was analyzed using logistic regression and presented as odds ratios (ORs) and 95% confidence intervals (CIs). We also calculated hazard ratios (HRs) and 95% CIs for the associations of lifestyle risk factors and endoscopic and histological parameters with incident gastric cancers using Cox regression models. Additionally, the proportion of cancers attributable to modifiable risk factors was calculated. During 9,096 person-years of follow-up, 36 new cases of gastric cancer were observed (incidence rate: 3.96/1,000 persons-years). Opium consumption was strongly associated with baseline antral (OR: 3.2; 95% CI: 1.2-9.1) and body intestinal metaplasia (OR: 7.3; 95% CI: 2.5-21.5). Opium (HR: 3.2; 95% CI: 1.4-7.7), hookah (HR: 3.4; 95% CI: 1.7-7.1) and cigarette use (HR: 3.2; 95% CI: 1.4-7.5), as well as high salt intake, family history of gastric cancer, gastric ulcer and histological atrophic gastritis and intestinal metaplasia of body were associated with higher risk of gastric cancer. The fraction of cancers attributable jointly to high salt, low fruit intake, smoking (including hookah) and opium was 93% (95% CI: 83-98). Hookah and opium use are risk factors for gastric cancer as well as for precancerous lesions. Hookah, opium, cigarette and high salt intake are important modifiable risk factors in this high-incidence gastric cancer area.
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Affiliation(s)
- Alireza Sadjadi
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Ghafouri HB, Saravani S, Shokraneh F. Burden of circulatory system diseases and ignored barriers of knowledge translation. J Cardiovasc Thorac Res 2012; 4:89-94. [PMID: 24250994 DOI: 10.5681/jcvtr.2012.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2012] [Accepted: 10/18/2012] [Indexed: 11/17/2022] Open
Abstract
Circulatory system disease raise third highest disability-adjusted life years among Iranians and ischemic cardiac diseases are main causes for such burden. Despite available evidences on risk factors of the disease, no effective intervention was implemented to control and prevent the disease. This paper non-systematically reviews available literature on the problem, solutions, and barriers of implementation of knowledge translation in Iran. It seems that there are ignored factors such as cultural and motivational issues in knowledge translation interventions but there are hopes for implementation of started projects and preparation of students as next generation of knowledge transferors.
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Affiliation(s)
- Hamed-Basir Ghafouri
- Emergency Department, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Khalili A, Yaghoubi A, Safaie N, Eyvazi K, Azarfarin R, Ebrahimzadeh A, Alizadehasl A, Safarzadeh G, Farzandan A, Zamanzadeh A. Incidence of Cardiovascular Risk Factors in Oskoo (Northwest Iran): An Approach through WHO CVD-risk Management Package for Low-and Medium-Resource Settings on 37,329 Adults ≥30 Years Old. J Cardiovasc Thorac Res 2011; 3:103-8. [PMID: 24250965 PMCID: PMC3825343 DOI: 10.5681/jcvtr.2011.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Accepted: 10/02/2011] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION The aim of this study was to determine incidence of cardiovascular disease (CVD) risk factors [hypertension (HTN), obesity, Dyslipidemia (DLP), diabetes mellitus (DM) and smoking] in Oskoo. METHODS This study was planned according to WHO protocol "WHO CVD-risk management package for low and medium-resource settings" and named "East Azerbaijan healthy heart program". The pilot study of this program was done in Oskoo in 2007-2009. In this study, demographic data and CVD risk factors of 37,329 adults aged ≥30 years old living in Oskoo were collected. In addition, blood samples of 17,388 adults ≥40 years old were taken (free of charge) for assessment of serum glucose and lipid profile. RESULTS The study covered 93.52% of Oskoo town population aged≥30 years old. We studied 18637 male (91.50% coverage) and 18692 female (95.52% coverage) participants. The incidence of HTN [SBP≥140 & DBP≥90 mmHg] was 16.25% (M:15.08%, F:17.29%), pre-hypertension [SBP=120-139 & DBP=80-89 mmHg] =37.78% (M:41.38%, F:34.18%), DM [fast blood glucose (FBS)≥126mg/dl] was 7.45% (M:6.35%, F:8.54%), smoking was 9.40% (M:17.00%, F:1.57%), hypercholesterolemia (>200mg/dl) was 47.64% (M:42.46%, F:52.81%) and obesity [body mass index (BMI) ≥27] was 50.47% (M:38.79%, F:62.09%). CONCLUSION Considering high incidence of CVD risk factors (except smoking) in Oskoo adults ≥30 years, it is recommended that this pilot study expanded to all of East Azerbaijan. Free of charge taking blood samples from people ≥ 40 years to evaluate lipid profile and glucose levels is worthy to early detecting the prevalent DM or DLP in this target population.
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Affiliation(s)
- Ahmadali Khalili
- Department of Cardiac Surgery, Madani Heart Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Yaghoubi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Naser Safaie
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Karim Eyvazi
- Oskoo Health and Treatment Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rasoul Azarfarin
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Adel Ebrahimzadeh
- Oskoo Health and Treatment Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azin Alizadehasl
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ghader Safarzadeh
- Biochemical Laboratory, Oskoo Health and Treatment Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abbas Farzandan
- Biochemical Laboratory, Oskoo Health and Treatment Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Zamanzadeh
- Biochemical Laboratory, Oskoo Health and Treatment Center, Tabriz University of Medical Sciences, Tabriz, Iran
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