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- Koochek, Afsaneh, et al.
(författare)
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Dietary differences between elderly Iranians living in Sweden and Iran a cross-sectional comparative study
- 2011
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 11, s. 411-
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Tidskriftsartikel (refereegranskat)abstract
- Background: During the last decades, global migration has increased and many immigrant groups have a higher prevalence than the native born population of several cardiovascular disease risk factors, including poor dietary habits. However, it is uncertain if dietary habits in immigrant populations reflect dietary habits in their country of origin or if the current diet is a consequence of the migration and possible change of dietary habits. The aim of this study was to examine possible dietary differences between elderly Iranians living in Stockholm, Sweden with elderly Iranians living in Tehran, Iran, taking into account sex, age, marital status, and education. Methods: Dietary intakes were assessed by semi - quantitative food frequency questionnaire in a cross-sectional study of 121 Iranians living in Stockholm and 52 Iranians living in Tehran, aged 60-80. Differences in dietary habits between the two groups was analysed by bootstrapped regression analyses with 1000 replications. Results: Iranians living in Sweden had significantly higher intake of protein, total fat, fiber than Iranians living in Iran, but lower consumption of carbohydrates. The observed differences in intake of macronutrients were reflected in consumed amount of all food items, which were higher among Iranians living in Iran with the exception of bread and grain consumption which was lower. Conclusions: There are general differences in dietary habits between Iranians living in Iran and Iranians living in Sweden. Parts of observed differences in dietary habits may reflect a favourable adoption process to the Swedish dietary habits after migration. Meanwhile other differences are point of concern in light of the high prevalence of overweight, among Iranians living in Sweden and can have unfavourable impact in particular in the context of cardiovascular health.
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2. |
- Koochek, Afsaneh, et al.
(författare)
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Is migration to Sweden associated with increased prevalence of risk factors for cardiovascular disease?
- 2008
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Ingår i: European Journal of Cardiovascular Prevention & Rehabilitation. - : Sage Publications. - 1741-8267 .- 1741-8275. ; 15:1, s. 78-82
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: [corrected] The proportion of elderly immigrants in Sweden is increasing. This is an important issue considering that the prevalence of cardiovascular disease (CVD) is a global health problem and that CVD is one of the main causes of morbidity among the elderly. The aim of this study is to analyze whether there is an association between migration status, that is being an elderly Iranian immigrant in Sweden, as compared with being an elderly Iranian in Iran, and the prevalence of risk factors for CVD. DESIGN: Population-based cross-sectional study with face-to-face interviews. PARTICIPANTS AND SETTING: A total of 176 Iranians in Stockholm and 300 Iranians in Tehran, aged 60-84 years. METHODS: The prevalence of general obesity, abdominal obesity, hypertension, smoking, and diabetes was determined. Unconditional logistic regression analysis was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for outcomes. RESULTS: The age-adjusted risk of hypertension and smoking was higher in Iranian women and men in Sweden. OR for hypertension was 1.9 (95% CI: 1.1-3.2) for women and 3.1 (95% CI: 1.5-6.3) for men and OR for smoking was 6.9 (95% CI: 2.2-21.6) for women and 4.7 (95% CI: 2.0-11.0) for men. The higher risk for hypertension and smoking remained significant after accounting for age, socioeconomic status, and marital status. Abdominal obesity was found in nearly 80% of the women in both groups. CONCLUSION: The findings show a strong association between migration status and the prevalence of hypertension and smoking. Major recommendation for public health is increased awareness of CVD risk factors among elderly immigrants.
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4. |
- Barkhordari, Mahnaz, et al.
(författare)
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Stata Modules for Calculating Novel Predictive Performance Indices for Logistic Models
- 2016
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Ingår i: International Journal of Endocrinology and Metabolism. - : Briefland. - 1726-9148 .- 1726-913X. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Prediction is a fundamental part of prevention of cardiovascular diseases (CVD). The development of prediction algorithms based on the multivariate regression models loomed several decades ago. Parallel with predictive models development, biomarker researches emerged in an impressively great scale. The key question is how best to assess and quantify the improvement in risk prediction offered by new biomarkers or more basically how to assess the performance of a risk prediction model. Discrimination, calibration, and added predictive value have been recently suggested to be used while comparing the predictive performances of the predictive models’ with and without novel biomarkers.Objectives: Lack of user-friendly statistical software has restricted implementation of novel model assessment methods while examining novel biomarkers. We intended, thus, to develop a user-friendly software that could be used by researchers with few programming skills.Materials and Methods: We have written a Stata command that is intended to help researchers obtain cut point-free and cut point-based net reclassification improvement index and (NRI) and relative and absolute Integrated discriminatory improvement index (IDI) for logistic-based regression analyses.We applied the commands to a real data on women participating the Tehran lipid and glucose study (TLGS) to examine if information of a family history of premature CVD, waist circumference, and fasting plasma glucose can improve predictive performance of the Framingham’s “general CVD risk” algorithm.Results: The command is addpred for logistic regression models.Conclusions: The Stata package provided herein can encourage the use of novel methods in examining predictive capacity of ever-emerging plethora of novel biomarkers.
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5. |
- Barkhordari, Mahnaz, et al.
(författare)
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Survival Regression Modeling Strategies in CVD Prediction
- 2016
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Ingår i: International journal of endocrinology and metabolism. - : Research Institute For Endocrine Sciences and Iran Endocrine Society. - 1726-9148 .- 1726-913X. ; 14:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: A fundamental part of prevention is prediction. Potential predictors are the sine qua non of prediction models. However, whether incorporating novel predictors to prediction models could be directly translated to added predictive value remains an area of dispute. The difference between the predictive power of a predictive model with (enhanced model) and without (baseline model) a certain predictor is generally regarded as an indicator of the predictive value added by that predictor. Indices such as discrimination and calibration have long been used in this regard. Recently, the use of added predictive value has been suggested while comparing the predictive performances of the predictive models with and without novel biomarkers. Objectives: User-friendly statistical software capable of implementing novel statistical procedures is conspicuously lacking. This shortcoming has restricted implementation of such novel model assessment methods. We aimed to construct Stata commands to help researchers obtain the aforementioned statistical indices. Materials and Methods: We have written Stata commands that are intended to help researchers obtain the following. 1, Nam-D'Agostino X-2 goodness of fit test; 2, Cut point-free and cut point-based net reclassification improvement index (NRI), relative absolute integrated discriminatory improvement index (IDI), and survival-based regression analyses. We applied the commands to real data on women participating in the Tehran lipid and glucose study (TLGS) to examine if information relating to a family history of premature cardiovascular disease (CVD), waist circumference, and fasting plasma glucose can improve predictive performance of Framingham's general CVD risk algorithm. Results: The command is adpredsurv for survival models. Conclusions: Herein we have described the Stata package "adpredsurv" for calculation of the Nam-D'Agostino X2 goodness of fit test as well as cut point-free and cut point-based NRI, relative and absolute IDI, and survival-based regression analyses. We hope this work encourages the use of novel methods in examining predictive capacity of the emerging plethora of novel biomarkers.
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6. |
- Bentham, James, et al.
(författare)
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A century of trends in adult human height
- 2016
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Ingår i: eLIFE. - 2050-084X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.522.7) and 16.5 cm (13.319.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
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7. |
- Bentham, James, et al.
(författare)
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A century of trends in adult human height
- 2016
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Ingår i: eLIFE. - : eLife Sciences Publications Ltd. - 2050-084X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3– 19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8– 144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
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8. |
- Bozorgmanesh, Mohammad Reza, et al.
(författare)
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Temporal Changes in Anthropometric Parametersand Lipid Profile according to Body Mass Indexamong an Adult Iranian Urban Population
- 2008
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Ingår i: Annals of Nutrition and Metabolism. - 0250-6807 .- 1421-9697. ; 53, s. 13-22
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To examine changes in anthropometric parametersand lipid profiles over a period of 3.6 years in an Iranian adultpopulation according to body mass index (BMI) groups.Methods: Between 1998 and 2001 (phase 1) and 2002 and2005 (phase 2), 5,618 nondiabetic Iranian adults aged 6 20years were examined. Analysis of covariance was used to delineatetrends in anthropometric parameters as well as totaland low- and high-density lipoprotein cholesterol (TC, LDL-Cand HDL-C, respectively) across BMI groups. Results: AlthoughBMI increased in women, this increase was not significantin obese persons. Among the men, however, a significantincrease in BMI was observed only in lean persons.Waist circumference (WC) increased across all BMI groupsin both sexes. A significant decrease was observed in TC[men: –0.83 mmol/l, 95% confidence interval (CI) –1.27 to–0.40; women: –0.78 mmol/l, CI –0.97 to –0.60] and LDL-C(men: –0.63 mmol/l, CI –1.13 to –0.13; women: –0.51 mmol/l,CI –0.78 to –0.24). A significant decrease in mean HDL-Cwas observed only among men (–0.09 mmol/l, CI –0.13to –0.04), with no difference among BMI groups (p = 0.3).There were no significant decreases in TC/HDL-C and LDLC/HDL-C ratios in men or women. Conclusions: Despite an increase in WC, favorable trends were observed in TC andLDL-C levels. The favorable trend in TC levels was counterbalancedby changes in HDL-C, as reflected by the absence of asignificant decrease in TC/HDL-C or LDL-C/HDL-C
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10. |
- Hadaegh, Farzad, et al.
(författare)
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The metabolic syndrome and incident diabetes: Assessmentof alternative definitions of the metabolic syndrome in anIranian urban population
- 2008
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Ingår i: Diabetes Research and Clinical Practice. - 0168-8227 .- 1872-8227.
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To compare the ability of definitions of Metabolic Syndrome (MetS) in the predictionof type 2 diabetes.Methods: We examined 4756 subjects in an Iranian population who were non-diabetic atbaseline. After 3.6 years, 188 individuals developed diabetes.Results: Impaired glucose tolerance (IGT) and MetS definitions predicted type 2 diabetes withodds ratios ranging from 3.7 to 11.9 (all P < 0.05) although IGT had the highest area under thereceiver operator characteristic (aROC) curve than all the MetS definitions. Reduction ofglucose in the National Cholesterol Education Program (NCEP) definition of the MetSincreased diabetes prediction, but adding the family history of diabetes did not changeaROC curves. The International Diabetes Federation (IDF) definition had the highest sensitivityand false positive rate (72.2 and 35.1%, respectively) and the WHO definition had thelowest ones (54.8 and 9.2%, respectively) for predicting diabetes. The positive predictivevalues of all definitions were low (8.6–19.7%) but their negative predictive values werearound 98%.Conclusions: In Iranian population, the MetS was inferior to IGT for predicting type 2diabetes. The NCEP definition of the MetS with reduced level of glucose (not includingthe family history of diabetes) and IDF definition predicted type 2 diabetes at least as well asWHO definition.
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11. |
- Lee, Crystal Man Ying, et al.
(författare)
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Comparing different definitions of prediabetes with subsequent risk of diabetes: an individual participant data meta-analysis involving 76 513 individuals and 8208 cases of incident diabetes.
- 2019
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Ingår i: BMJ open diabetes research & care. - : BMJ. - 2052-4897. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- There are currently five widely used definition of prediabetes. We compared the ability of these to predict 5-year conversion to diabetes and investigated whether there were other cut-points identifying risk of progression to diabetes that may be more useful.We conducted an individual participant meta-analysis using longitudinal data included in the Obesity, Diabetes and Cardiovascular Disease Collaboration. Cox regression models were used to obtain study-specific HRs for incident diabetes associated with each prediabetes definition. Harrell's C-statistics were used to estimate how well each prediabetes definition discriminated 5-year risk of diabetes. Spline and receiver operating characteristic curve (ROC) analyses were used to identify alternative cut-points.Sixteen studies, with 76513 participants and 8208 incident diabetes cases, were available. Compared with normoglycemia, current prediabetes definitions were associated with four to eight times higher diabetes risk (HRs (95% CIs): 3.78 (3.11 to 4.60) to 8.36 (4.88 to 14.33)) and all definitions discriminated 5-year diabetes risk with good accuracy (C-statistics 0.79-0.81). Cut-points identified through spline analysis were fasting plasma glucose (FPG) 5.1mmol/L and glycated hemoglobin (HbA1c) 5.0% (31 mmol/mol) and cut-points identified through ROC analysis were FPG 5.6mmol/L, 2-hour postload glucose 7.0mmol/L and HbA1c 5.6% (38 mmol/mol).In terms of identifying individuals at greatest risk of developing diabetes within 5years, using prediabetes definitions that have lower values produced non-significant gain. Therefore, deciding which definition to use will ultimately depend on the goal for identifying individuals at risk of diabetes.
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12. |
- Ordookhani, Arash, et al.
(författare)
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Seasonal variation of neonatal transient hyperthyrotropinemia in tehran province, 1998–2005
- 2010
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Ingår i: Chronobiology International. - : Informa Healthcare. - 0742-0528 .- 1525-6073. ; 27:9-10, s. 1854-1869
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Tidskriftsartikel (refereegranskat)abstract
- Seasonal aggregation and the monthly rate of neonatal transient hyperthyrotropinemia(THT) were assessed. From November 1998 to April 2005, neonates of gestationalage ≥37 wks, birth weight 2500–4000 g, birth length 45–55 cm, and 1st min Apgarscore >3, who had thyrotropin (TSH) ≥20 mU/L in their cord dried-blood specimen,but without congenital hypothyroidism, were enrolled in the study. The recall rateequals the rate of THT occurrence in this study. Of 47,945 neonates, 555 had THT(recall rate: 1.2%). The aggregated seasonal recall rate (recall for further assessment torule out congenital hypothyroidism) was significantly higher in winter (January,February, and March) than the other seasons ( p < .0001). Winter had higher recallrate in each year as compared to other seasons, but the overall rate of recalls decreasedin 2001 and 2002. Excluding the first 6 months (due to erratic variations), the remaining72 months revealed a relatively sinusoidal pattern in monthly recall rates; indeed,there was an initial 11-month high recall rates (1.7%), followed by a 33-month decrease(0.7%), a 19-month increase (1.9%), and a final 9-month decrease (0.8%). The recallrate of each of these time intervals was significantly different from that of the nexttime interval ( p < .0001). The monthly recall rates were best fitted to cubic curve estimationand then autoregressive integrated moving average (ARIMA) (0, 1, 1) models.THT occurs significantly more in winter than in other seasons, and this suggests apossible role for time-varying factor(s) contributing to its seasonal preponderance.
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13. |
- Rambod, Mehdi, et al.
(författare)
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Fine-tuning of prediction of isolated impaired glucosetolerance: A quantitative clinical prediction model
- 2008
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Ingår i: Diabetes Research and Clinical Practice. - 0168-8227 .- 1872-8227.
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Tidskriftsartikel (refereegranskat)abstract
- In this cross-sectional study, we evaluated results of oral glucose tolerance test (OGTT) from4742 women and 3470 men, participated in the Tehran Lipid and Glucose Study, aged 20years and without diabetes, to determine the diagnostic value of subjects’ clinical traits withisolated impaired glucose tolerance (isolated-IGT) defined as fasting plasma glucose (FPG)<5.6 mmol/L and 2-h plasma glucose between 7.8 and 11.1 mmol/L. The overall prevalenceof IGT was 13.6% (n = 1120); of these subjects, 59.6% (n = 668) had isolated-IGT. The adjustedodds ratios for having isolated-IGT among 7012 subjects with FPG <5.6 mmol/L weresignificant for age 40 years (2.5), hypertension (1.9), abnormal waist circumference (1.9),obesity (1.5), and family history of diabetes (1.3). Adding the lipid profiles to the clinicalmodel increased the area under the ROC curve only slightly (73.2% vs. 72.1%, respectively;P = 0.002). In summary, this study showed that in adults with FPG <5.6 mmol/L, older age,family history of diabetes, abnormal waist circumference and obesity, and hypertensionwere significantly associated with a higher likelihood of isolated-IGT; OGTT could hence berecommended in subjects who have most of these characteristics to find Isolated-IGT,especially if the findings are supported by appropriately designed clinical trials.
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14. |
- Styrkarsdottir, Unnur, et al.
(författare)
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Whole-genome sequencing identifies rare genotypes in COMP and CHADL associated with high risk of hip osteoarthritis
- 2017
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Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 49:5, s. 801-805
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Tidskriftsartikel (refereegranskat)abstract
- We performed a genome-wide association study of total hip replacements, based on variants identified through whole-genome sequencing, which included 4,657 Icelandic patients and 207,514 population controls. We discovered two rare signals that strongly associate with osteoarthritis total hip replacement: a missense variant, c.1141G>C (p.Asp369His), in the COMP gene (allelic frequency = 0.026%, P = 4.0 × 10-12, odds ratio (OR) = 16.7) and a frameshift mutation, rs532464664 (p.Val330Glyfs∗106), in the CHADL gene that associates through a recessive mode of inheritance (homozygote frequency = 0.15%, P = 4.5 × 10-18, OR = 7.71). On average, c.1141G>C heterozygotes and individuals homozygous for rs532464664 had their hip replacement operation 13.5 years and 4.9 years earlier than others (P = 0.0020 and P = 0.0026), respectively. We show that the full-length CHADL transcript is expressed in cartilage. Furthermore, the premature stop codon introduced by the CHADL frameshift mutation results in nonsense-mediated decay of the mutant transcripts.
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15. |
- Zhou, Bin, et al.
(författare)
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Worldwide trends in diabetes since 1980: A pooled analysis of 751 population-based studies with 4.4 million participants
- 2016
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Ingår i: The Lancet. - : Elsevier B.V.. - 0140-6736 .- 1474-547X. ; 387:10027, s. 1513-1530
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Tidskriftsartikel (refereegranskat)abstract
- Background: One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are aff ecting the number of adults with diabetes.Methods: We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence-defined as fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs-in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue.Findings: We used data from 751 studies including 4372000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-17.0) in 1980 to 9.0% (7.2-11.1) in 2014 in men, and from 5.0% (2.9-7.9) to 7.9% (6.4-9.7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28.5% due to the rise in prevalence, 39.7% due to population growth and ageing, and 31.8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target.Interpretation: Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults aff ected, has increased faster in low-income and middle-income countries than in high-income countries.
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