جستجوی مقالات مرتبط با کلیدواژه « مطالعه ی قند و لیپید تهران » در نشریات گروه « پزشکی »

Obesity predisposes individuals to functional decline and low self-esteem. Therefore, perceived social support can be a key determinant of individuals' reactions to this phenomenon and their health-related quality of life (HRQoL). The present study aimed to compare the association between HRQoL and perceived social support in overweight/obese adults in Tehran, Iran.

A total of 1674 participants of Tehran Lipid and Glucose Study, aged ≥20 years, were enrolled in this study. To collect data, the perceived social support, HRQoL, and demographic information questionnaires were used. The participants were categorized into two groups of normal weight and overweight (73.6%), according to the body mass index (BMI).

The mean age of the participants was 47.96±15.25 years, and 57.8% (n=963) of them were female. In both groups of low and high social support, the physical functioning score of HRQoL was significantly higher in normal-weight individuals, compared to their overweight/obese counterparts (OR: 1.94, CI: 1.21-3.10).

After adjusting for demographic, behavioral, and clinical factors in the group with lower levels of perceived social support, it was found that the likelihood of poor physical functioning, as a component of HRQoL, in overweight/obese individuals was almost twice as high as those with a normal weight.

As fertilization preventing behaviors is one of the most important components of demographic trends, population policies predominantly focuses on family planning. Due to the reduction in population growth of Iran, population policies have been changed somewhat. This study was conducted to explore the impact of changes in population policy approach on the trend of contraceptive methods usage in recent 10 years.
In this population-based cross-sectional study, the prevalence of different contraceptive methods usage was evaluated in four years of 1381, 1384, 1387 and 1390 using the collected data through Tehran Lipid and Glucose study (TLGS).
The results showed that the use of the modern contraception and the traditional contraception methods have been increased and decreased across the time, respectively. Childbirth tendency were slowly increasing among women younger than 35 years. At the same time the use of male methods, especially condoms had a regular increasing trend, while female methods, including IUD, pills, injection had a decreasing trend. In this respect, at the end of decade (Phase 4), the prevalence of using male contraceptive methods, especially condom, was more than female methods which had no significant association with women’s educational level or parity (p=0.15 and P=0.08, respectively).
It seems that the changes of population policy have been gradually caused a reduction in modern contraceptive methods usage. Understanding about these trends could help the health care policy makers to predict, design and implement the future decisions, and would provide valuable strategies to determine accurate health policies in the country.

Identifying different food patterns may play a role in reducing the incidence of hypertension. Since most studies in this field have been cross-sectional, studies demonstrating HTN incidence are very limited. Hence we conducted this longitudinal study to determine dietary patterns and their effects on the incidence of hypertension. Dietary patterns of 1787 subjects, aged 20-60 yrs, who participated in phase 3 of Tehran Lipid and Glucose Study (TLGS) were determined using factor analysis and the association between dietary patterns and the incidence of hypertension in phase 4 of TLGS was assessed, using logistic regression. Mean age across quartiles of healthy and western dietary patterns differed significantly. Individuals with lowest adherence to healthy dietary pattern and highest adherence to western dietary pattern were younger than others. Participants in the highest quartile of the healthy dietary pattern were physically more active than those in the upper quartile of western dietary pattern, who had the lowest level of physical activity. The healthy dietary pattern was negatively associated with elevated systolic blood pressure in models 2 (adjusted for age, sex, education, smoking and BMI) and 3 (adjusted for age, sex, education, smoking and BMI and physical activity) (odds ratio: 0.74 (95% CI: 0.56-0.98) and 0.74 (95% CI: 0.56-0.97) respectively, P=0.03 for both). Results of this study showed that adherence to the healthy dietary pattern reduced the risk of incidence of hypertension by 26%.

Dietary energy-dense foods predispose to obesity and may be associated with risk of type 2 diabetes; therefore, the aim of our study was to investigate the association between dietary energy density (DED) and the risk of type 2 diabetes. In this matched nested case-control study, 178 new onset cases of diabetes were selected from among participants of the Tehran Lipid and Glucose Study, and followed for over 9 years. Each case was randomly matched with 3 controls from among participants who had not developed diabetes. Dietary intakes were determined using a valid and reliable food frequency questionnaire. DED was calculated as energy intakes (kcal) from foods and beverages divided by the weight (grams) of foods. The mean ages of participants were 43±6.5 and 44.5±12 years, in women and men respectively. Individuals with higher DED had higher calories, total fat, carbohydrate and processed meat intakes and lower fruit and vegetable intakes in men and women (P<0.05). Energy density was positively associated with incident diabetes in women, after adjustment for diabetes risk factors and total calorie intake (OR: 2.28, P trend=0.02) or total fat intake (OR: 2.15, P trend=0.03), an association which was not significant in men. In this nested case-control study, there was positive association between DED and risk of type 2 diabetes in women.

Menopause is defined as 12 months of constant amenorrhea in the absence of any pathology. Right now there is no definite test to predict menopause age and the ovarian reserve evaluations are mainly implemented on the basis of sonographic and hormonal measurements. The present study was conducted to determine and compare the menopausal age in women with polycystic ovarian syndrome (PCOS) and non PCOS women based on anti-mullerian hormone (AMH). The present study is an epidemiologic case- control research in which from among 1019 women aged 20-40years، 208 PCOS women and 811 normo-ovulatory controls were selected as the case and control groups respectively. Data collection was done through completing questionnaire، clinical examination and lab test measurements. After age and body mass index (BMI) matching، AMH levels in relation to age were displayed in an interactive graph and SPSS software version 21 was used for statistical analysis. Findings showed the mean age and BMI for case and control groups were 29. 75 years – 27. 1 (kg/m2) and 31. 62 years – 26. 1 (Kg/m2) respectively. Our results indicated significantly higher AMH levels in PCOS cases than in normal controls (P<0. 0001). The estimated menopausal age for PCOS and non PCOS women was 51 and 49 years respectively. To conclude PCOS patients reach menopause two years later than healthy women. If the length of reproductive period in these patients is higher than that the healthy women، it may be possible to use this period for increasing the fertility likelihood.

Epidemiological studies show that consumption of dairy products plays an important role in prevention and treatment of the metabolic syndrome (MetS). The objective of this study is to examine the relation between dairy intake with MetS and its components in Tehranian adolescents. In this cross-sectional study، 785 adolescents، aged 10 to 19 years، participants of the fourth phase of the Tehran Lipid and Glucose Study were selected. Usual dietary intake was assessed using a valid semi-quantitative food frequency questionnaire. Total dairy، low fat and high fat dairy، milk، yoghurt and cheese were and anthropometrics، biochemical measurements and blood pressure were assessed. MetS was defined according to the de Ferranti criteria. Mean age of subjects was 14. 8 ± 2. 9 years. The prevalence of MetS was 22. 2% (girls: 19. 5% and boys: 25. 2%). The most prevalent component for MetS among boys was high waist circumference (53. 4%) and among girls was low HDL-C (53. 1%). Energy density and intake of protein، total fat، saturated fat، cholesterol، calcium and phosphor were higher in the highest quartile of dairy consumption، than in the lowest quartile. After adjustment for confounders، odds ratios with 95% confidence interval for MetS in the highest quartiles of total dairy، low fat dairy، high fat dairy، milk، yoghurt and cheese were 0. 97 (0. 57-1. 66)، 1. 44 (0. 83-2. 49)، 0. 97 (0. 56-1. 67)، 0. 70 (0. 42-1. 18)، 1. 62 (0. 99-2. 64)، 0. 72 (0. 44-1. 18) respectively، compared to the lowest quartile. Results of this study do not support the hypothesis that consumption of dairy products protects against MetS and its components.

Hirsutism is a common endocrine disorder among reproductive women. There is no clear definition and criterion for the clinical evaluation and diagnosis of hirsutism. The aim of present study is to introduce a simpler diagnostic method on the basis of modified Ferriman- Gallwey (mF-G) system، which examines fewer body areas، but with the same sensitivity، spec­ificity and positive predictive value (PPV). A one thousand women، aged 18-45 years، participants of the Tehran Lipid and Glucose Study، were recruited by random systematic sampling. Data were collected by a questionnaire and clinical examination. The total mF-G score was calculated and ROC curve was drawn for subsets of areas. The new cut-off points were calculated for those subsets with optimal sensitivity، specificity، positive and negative predictive value and concordance percentage. The subset of 5 areas of the lips، chin، thighs، upper and lower abdomen (cut-off point 5)، had sensitivity and specificity of 97/5% and 89/9% (R²= 0/92%، P<0. 0001) respectively، and was the nearest subset to mF-G method. The subset of lip، abdomen and thighs (cut- off point 4) was 91/5% sensitive and 92% specific، with the highest PPV (72/2%) and concordance percentage (91/9%) with the golden standard (mF-G score ≥ 8). Using the 3 area subset of lip+ lower abdomen+ thighs serves as a simple and more accepted method for hirsutism assessment and can be used in wide epidemiologic studies.

Few studies have used lifestyle modification to prevent obesity at the community level. The aim of this study was to determine the effects of lifestyle modification education on the prevalence of general and central obesity in adults. We studied 3270 men (1205 and 2065 individuals in the intervention and control groups، respectively) and 4464 women (1670 and 2794 individuals in the intervention and control groups، respectively). They participated in Tehran Lipid and Glucose Study during 1999-2011. Demographic characteristics، behavioral habits، and obesity status of the participants were assessed through four cross-sectional surveys with 3-year intervals. The intervention included education for improving diet and physical activity and decreasing smoking through counseling، lectures، and publications. The mean age of men and women was 44. 2 ± 14. 9 and 42. 1±13. 7 years، respectively. During a median follow-up of 9. 9 years، the intervention had no significant impact on the odds of becoming obese in non-obese men and women. However، it resulted in 0. 27 and 0. 38 decreases in the odds of continuing to be obese in obese men and women، respectively. The changes were only significant in women (P = 0. 003). In addition، the intervention reduced the odds of central obesity by 0. 34 in the women with central obesity (P = 0. 002). However، it had no significant effects on central obesity among other participants. Population-based interventions can be beneficial in reducing the prevalence of general and central obesity in adults. These effects are stronger in women than in men. Thus، implementing interventional programs among non-obese individuals is necessary.

Leisure-time physical activity (LTPA), as a lifestyle-related behavior, could be a preventive factor for metabolic syndrome (MetS). We aimed to examine the association between LTPA and MetS among the adults who participated in the Tehran Lipid and Glucose Study (TLGS). In the present cross-sectional study, 4665 adults (1976 males and 2686 females), aged 20-70 years, were selected by multi-stage random cluster sampling from among TLGS participants. Subjects were classified according to their BMI. LTPA was determined via a validated and Modifiable Activity Questionnaire (MAQ), and MetS, according to the JIS criteria. Prevalence of the MetS was higher in obese groups (58.2%) compared to the overweight (36.6%) and normal weight (6%) ones (p<0.001). Normal weight subjects (18.1%) were physically more active than other groups. In the normal weight group with light LTPA, the risk of lower levels of HDL-C and elevated levels of TG were higher than in individuals with vigorous LTPA (OR: 1.15; CI95% 1.05, 2.33) (OR: 1.46; CI95% 1.01, 2.14). In the overweight group, the probability of elevated levels of FBS was higher among individuals with moderate LTPA than in those with vigorous LTPA (OR: 1.65 CI95% 1.37, 3.23), and there was also an inverse association between light LTPA and MetS (OR: 2.08; CI95% 1.03, 4.21). This study confirmed that increased levels of LTPA are associated with a decreased likelihood of any inappropriate changes in components of Mets and the occurrence of Mets.

Logic regression is a generalized regression method that can identify complex Boolean interactions of binary variables. This method has been successfully used for analyzing single-nucleotide polymorphism data, because in SNP association studies interactions are important. The aim of this study is to investigate the associations between some candidate gene polymorphisms and HDL concentration using Logic Regression. Subjects for this cross sectional study, 436 subjects (172 men and 264 women) aged≥20 with some polymorphisms, were randomly selected from among participants of the Tehran Lipid and Glucose Study (TLGS). Logic regression analysis was used to identify combinations of main genetic effects and interactions associated with HDL. Cross validation and randomization test were done to avoid over fitting of the models. Cross validation test suggested that the Logic model with four Boolean combinations and four predictors was the best logic model, which after fitting, showed that individuals who carry Apoe SNP ε3 or have high TG have an odds ratio of 2.35 (CI 95%:1.3-4.25) for having low HDL compared to other subjects. Also subjects with high TG have odds ratio 2.73 (CI 95%: 1.65,4.53) for having low HDL. Results of this study shows that Logic Regression is a powerful method to determine the interaction effect between high TG and ApoE SNP for having low HDL.

In the rapidly increasing elderly population of Iran, no prospective health studies have yet been undertaken. This study was conducted to identify the risk factors of survival time of elderly Tehranians, aged above 60 years.

Individuals aged above 60 years old (n=929), recruited in the primary phase (1998-2001) of the ongoing Tehran Lipid and Glucose Study (TLGS), were followed up for 10 years and their vital statistics were documented (1998-2008). Age and sex mortality rates for age groups (60-69, 70-79, 80+) were calculated and the hazard rates were estimated using Cox proportional hazard model.

Of 929 males, 154 (17%) and out of 869 women 85(10%) died during the follow-up years. Cox model showed that diabetes, on an average, reduced 2.5 years and 4.4 years, while smoking reduced 6.6 and 5 years of female's and male's survival time, respectively. BMI>33Kg/m2 and dyslipoproteinemia reduced 4.5 years and 4 years of women's life spans, respectively. Native Tehranian males on an average, live 3 years less than other male residents; in addition, hypertension and history of MI, stroke or sudden death of father, brother or son reduced 3.3 years and 4.1 years of men's life time respectivly.

Elderly women with BMI>33 Kg/m2 and/or smokers and/or with dyslipoproteinemia are more in need of health care, while among their male countery parts elderly diabetic men and/or smokers and/or those who have history of MI, stroke or sudden death of a father, brother or son also need more attention.

Hypertension during pregnancy (HDP) is a gestational disease that occurs mainly among nul‌liparous women, Studies show conflicting results of its complications later in life. We hence aimed to assess metabolic and cardiovascular complications subsequent to preeclampsia in a cohort study.

Normotensive women, participants of the Tehran Lipid Glucose Study (TLGS) were selected and categorized in two groups: Group 1: 226 women with previous preeclampsia as the case group, and 226 age-BMI matched women without preeclampsia as the controls. Groups were followed 10 years and were compared for cardiovascular and metabolic disorders.

The incidence rate of type 2 diabetes mellitus in the case group was 3-fold higher than in controls (37.2% vs 12%). Incidence rates for hypertension and dislipidemia in the case group were also significantly higher than in controls (41.1 vs 19.5% for hypertension and 87.2 vs 66.3% for dislipidemia). Values for systolic blood pressure, fasting blood sugar and high-density lipoprotein (HDL) differed in phase 3 in the two groups.

Women with previous preeclampsia were at high risk of cardiovascular and metabolic disorders. Counseling, screening and providing health care can reduce their complications of preeclampsia, later in life.

Physical activities represent an independent risk factor for a number of chronic diseases. The aim of this study was to assess physical inactivity in a sample of Tehranian adults. We selected 7285 TLGS participants (≥ 20 years), who had completed physical activity questionnaires between 2002-2004. Leisure time physical activity level was assessed using the modifiable Activity Questionnaire (MAQ), with each activity being weighted by its relative intensity, referred to as a Metabolic Equivalent (MET). Subjects were asked to report the activities they had participated in during past 12 months and to estimate the frequency and duration for each leisure time activity indentified and were categorized into the active and inactive groups. The overall prevalence of inactivity was 69.8% and only 30.2% (95%CI=27.2-33.1%) of males and 30.3% (95%CI=27.7-32.8%) of females were considered active. In males, the prevalence of inactivity increased with age and the highest rate of physical inactivity was observed in the 40-49 year group. There was a statistically significant decrease in leisure time physical activity level (LTPA) with increasing body mass index, and smoking and hours of work. A positive association was observed between LTPA and high educational levels in males. Moreover, a statistically significant difference was found between the physical activity and occupations between men and women (p<0.05). Findings of the present study showed that a high prevalence of physical inactivity among Tehranian adults, raising concerns about public health, and necessitating health policies encouraging the population to be more active.

Menarcheal age is an important event in human life and is influenced by various genetic, demographic, socio-economic and inviromental factors. Limited current data shows controversy regarding the effect of antropometric and biochemical variables on age of menarche and the related factors among Iranian girls. The objective of the present study is to evaluate the effect of antropometric,demographic and serum lipoproteins on the age of menarche. in the present descriptive study, we enrolled 370 girls aged 10-16 year, from the Tehran Lipid and Glucose Study (TLGS), whose menstruation had begun 6 months prior to the study. The mean age of menarche, weight, height, waist circumference and body mass index were 12.6±1.1years, 53.7 ±10.5kg, 157.3±5.5cm, 72.5 ±9.8cm and 21.7 ±3.9 kg/m2, respectively. Although there were statistically significant relationships between age of menarche and body mass index, height, waist circumference and level of mother’s education, there was no significat correlation between menarcheal age and weight or serum lipoprotiens. Serum lipoprotiens were not found to have any influence on the menarcheal age in girls.

Several studies suggest that CRP plays a role in the pathogenesis of diabetes in adults. We tested the hypothesis that elevated levels of CRP at baseline can predict later onset of type 2 diabetes mellitus. In a nested case-control study, serum level of CRP was measured from stored samples of 73 control and 80 cases from among participants of the Tehran Lipid Glucose Study, who had been followed for 3.6 years. In age adjusted model, levels of CRP were associated with an increased risk of type2 diabetes, OR 3/6 (95%CI: 1.5 – 8.2) for tertile 3 versus 1, p.001. However in multivariate analysis the association between CRP and type 2 diabetes was significantly decreased after adjustment for fasting plasma glucose, body mass index, family history of diabetes, HOMA-IR, OR. 8 (95%CI:0.2 – 2.8) for tertile 3 versus 1, p 0.7. Elevated levels of CRP were associated with an increased risk of type 2 diabetes however, the association was not independent of other diabetes risk factors, including fasting plasma glucose, body mass index, HOMA-IR and family history of diabetes.

To examine the association between changes in body weight and body fat distribution and development of metabolic syndrome. Changes in body weight and body fat distribution and the appearance of metabolic syndrome over a 3 year duration were assessed in 2176 women of the Tehran Lipid and Glucose Study. Metabolic syndrome was defined according to ATPIII criteria. Body fat distribution was determined by waist to hip ratio, waist circumference and hip girth. Stable waist and hip were defined successively as±2cm and -2cm to 0cm, respectively. The mean age of subjects was 36.4±12.7 years and the incidence of metabolic syndrome was 19 percent during this period. After controlling for age, family history, smoking status and physical activity, weight gain was monotonically related to the risk of development of metabolic syndrome (for each Kg of weight gained, risk increased by 1.15%). Changes in waist to hip ratio of over 0.07 cm, were significantly associated with risk (P<0.05), independent of the risk associated with weight change. Compared with women who had a stable waist, ≥ 3cm increase in waist circumference had 3.33 times (95%CI: 2.14-5.22) the risk of metabolic syndrome and ≥ 5cm increase in hip girth had 1.58 times (95%CI: 0.99-2.54) the risk of metabolic syndrome. Findings show that changes in weight and body fat distribution are associated with the risk of metabolic syndrome.