Serum lipid levels in an Iranian population of children and adolescents: Tehran lipid and glucose study

Data from 3148 participants aged 3–19years (1447 males and 1701 females) in the cross-sectional phase of Tehran lipid and glucose study (February 1999–May 2000) were used to determine serum lipid levels [total cholesterol (TC), triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)] after 12–14 hours overnight fast. The values were analyzed by sex and age. Mean serum TC concentration was 170 mg/dl. TC was significantly greater in females than males (173 vs. 167 mg/dl, p < 0.05). The 90th and 95th percentiles for serum TC were 211 and 227 mg/dl, respectively. There was a significant decrease in mean TC in males during puberty. Thirty-one percent of population had TC values between 170 and 199 mg/dl and 16% had values of 200 mg/dl or greater. The mean TGs values were 103 for males and 108 mg/dl for females [non-significant (NS)]. The prevalence of high-risk values of TGs increased with age in males, reaching a peak at 17–19years. The mean HDL-C level was 45 mg/dl. Mean HDL-C was highest at 7–10years of age and decreased thereafter. The mean LDL-C was 102 in males and 107 mg/dl in females (NS). Twenty-two percent had LDL-C values between 110 and 129 mg/dl and 17% had values 130 mg/dl or greater. The results showed higher levels of TC, LDL-C and TGs and lower HDL-C in Tehranian children and adolescents than other studies. To design comprehensive public health programs to reduce serum lipid levels among Iranian children and adolescents, underlying factors for the high prevalence of dyslipoproteinemia should be sought.     

Serum lipid levels in an Iranian adults population: Tehran Lipid and Glucose Study

Data from 6246 participants aged 20–64 years (2339 males and 3907 females) in the cross-sectional phase of Tehran Lipid and Glucose Study (February 1999–May 2000) were used to determine distribution of serum lipid levels after 12–14 hour overnight fast. Mean total cholesterol (TC) concentration was 210 mg/dl. TC was significantly greater in females than males, 213 and 206 mg/dl, respectively (p < 0.0001). Thirty-one percent of population had TC values between 200 and 239 and 24% had values of 240 mg/dl or greater. Mean low-density lipoprotein cholesterol (LDL-C) was 129 and 135 mg/dl in males and females, respectively (p < 0.0001). Twenty-seven percent had LDL-C values between 130 and 159 and 23% had values 160 mg/dl or greater. The mean triglycerides (TGs) values were 190 and 162 mg/dl for males and females, respectively (p < 0.0001). The mean high-density lipoprotein cholesterol (HDL-C) was 39 in males and 45 mg/dl in females (p < 0.0001). The results showed higher levels of TC, LDL-C and TGs and slightly lower HDL-C in Tehranian adults than other studies in the industrialized countries.     

Cardiovascular risk factors in the urban Mexican population: the FRIMEX study

BACKGROUND: Atherosclerotic ischaemic heart disease is the second leading cause of general mortality in Mexico due to the growing prevalence of atherosclerotic risk factors in our society. The data of the FRIMEX study (Factores de Riesgo en México, Risk Factors in Mexico), considered together with those of other contemporary epidemiological surveys, will aid in our comprehension of the current state of cardiovascular epidemics in Mexico. METHODS: Frequencies of obesity, hypertension and smoking, and total cholesterol and glucose in capillary blood were estimated in a non-probabilistic sample comprised of 140017 individuals (aged 44+/-13 years; 42% men and 58% women), from six Mexican cities (Mexico City, Guadalajara, Monterrey, Puebla, Leon and Tijuana). RESULTS: Obesity or overweight status was found in 71.9% of participants. Hypertension was found in 26.5%, and the proportions of awareness, treatment and control for this disease were 49.3, 73 and 36%, respectively. Prevalence of hypertension increased with age; while it was higher in men under 60 years of age, in the more aged individuals it was higher in women. Hypercholesterolaemia was found in 40% of the individuals and cholesterolaemia > or =240 mg/dl was significantly higher in women. Thirty-five and a half percent of men and 18.1% of women were smokers. Type 2 diabetes mellitus was found in 10.4% of participants. There was significant Pearson's correlation between body mass index and blood pressure, between hypertension and glucose levels, and between hypertension and total cholesterol concentrations. CONCLUSIONS: We conclude that this population has a high cardiovascular risk profile and a high probability of the occurrence of metabolic syndrome.     

High prevalence of undiagnosed diabetes and abnormal glucose tolerance in the Iranian urban population: Tehran Lipid and Glucose Study

Background  

To estimate the prevalence of diagnosed and undiagnosed diabetes mellitus, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and combined IFG/IGT in a large urban Iranian population aged ≥ 20 years.     

Dietary factors and body mass index in a group of Iranian adolescents: Tehran lipid and glucose study--2

OBJECTIVE: To study the prevalence of overweight and obesity in an adolescent population in Tehran and to determine possible association with energy and nutrient intake and distribution of energy over the day. METHOD: A cross-sectional study on 177 boys and 244 girls between 10-19 years old was performed. Overweight and obesity were defined by using recommended body mass index (BMI) cut-off values for adolescents. Total energy intake, percent of energy derived from protein, carbohydrate and fat and percent of energy supplied by each meal and snack were assessed by means of two 24-hour dietary recalls. RESULTS: Prevalence of overweight and obesity was 10.7 and 5.1 in boys and 18.4 and 2.8 in girls, respectively. The composition of diet was not different between overweight/obese and normal weight subjects. BMI was related with breakfast energy percentage in girls (r = -0.18, p < 0.01), with total energy intake in boys (r = 0.23, p < 0.01), and with lunch energy percentage in both sexes. In boys (r = 0.16, p < 0.05) and in girls (r = 0.22, p < 0.01). CONCLUSION: High prevalence of overweight and obesity among adolescents was seen. In boys some relationship between total energy intake, distribution of energy over the day and BMI was seen. In girls BMI was only related with distribution of energy over the day.     

Association of educational level and marital status with dietary intake and cardiovascular risk factors in Tehranian adults: Tehran lipid and glucose study (TLGS)

This study was conducted to assess the association of educational level and marital status with dietary intake, obesity and other cardiovascular risk factors. 733 subjects, 408 women and 325 men, aged between 20-60 years, were randomly selected from the participants of the Tehran Lipid and Glucose Study. Data on educational level, and marital status were obtained by a questionnaire. Following measurement of weight, height, waist and hip according to standard protocol, body mass index (BMI) and waist to hip ratio (WHR) were calculated. Dietary intake was assessed by completing two 24-hour dietary recalls during face to face interviews. Serum cholesterol, triglycerides levels, and HDL cholesterol were measured after 12-14 hours fasting. Subjects were divided into four groups based on educational levels: illiterate or low literacy, intermediary school, high school and university graduates. Adjusted for age, increases in triglycerides levels in men with high educational levels were observed. In women with different educational levels, none of the studied variables differed. In married men total energy intake (3001 ± 625 vs. 2905 ± 543 Kcal/d, P < 0.05) and iron intake (29.0±8.1 vs. 28.1± 10 mg/d, P < 0.05) were significantly higher than in single men. BMI and WHR in single women were lower than in married ones (P < 0.05) and HDL-cholesterol was higher in single men (P < 0.05) and women (P < 0.01). We concluded that educational level and marital status has an association with BMI, WHR, serum lipid levels and dietary intake, in men and women.     

Cardiovascular disease risk factors in an Indochinese population

One hundred seventeen Indochinese adults were screened for heart disease risk factors at a San Diego community health facility during December 1986. Two levels of excess risk, moderate-high and high, were categorically defined for blood pressure, total cholesterol, cigarette smoking, and obesity. Overall, 61% were at moderate-high or high risk in at least one category, and 34% were at high risk by these criteria. Systolic blood pressure, diastolic blood pressure, and total cholesterol were positively correlated to age, and ethnicity was a significant covariate for cholesterol, body mass index, and cigarette smoking. The Hmong, compared with other Indochinese, had a significantly lower mean cholesterol level, which remained after adjusting for age and body mass. High rates of cigarette smoking were found among Vietnamese men and young Indochinese men. If confirmed, the high prevalence of heart disease risk factors in Indochinese refugees and immigrants suggests that cardiovascular health education programs are appropriate in Indochinese communities.     

Associations between dairy products consumption and risk of type 2 diabetes: Tehran lipid and glucose study

Abstract

We aimed to examine the relationship between total dairy and dairy subtypes with the risk of type 2 diabetes (T2DM) in an Asian population. A nested case–control study of 178 cases of incident T2DM and 520 matched controls was conducted within the Tehran lipid and glucose study (TLGS). A 27% lower risk of T2DM was found per 100?g/d total dairy consumption that tend to be significant (95% CI: 0.52–1.02). Milk intake was inversely associated with diabetes after adjustment for confounders (p-trend: 0.042). Milk intake was associated with decreased T2DM risk in men (p-trend: 0.025), but not in women (p-trend: 0.527). Each 100?g/d increase in milk intake corresponded to 41% lower T2DM risk in fully adjusted model (95% CI: 0.39–0.89) in men. In conclusion, there is no significant association between diabetes and total dairy intake in the present study, but high intake of milk may reduce T2DM risk among men.     

Estimation of energy requirements for adults: Tehran lipid and glucose study

OBJECTIVE: This study was conducted to determine the energy intake of adult residents of district 13 of Tehran and compare the results with their energy requirements. DESIGN: In this cross-sectional study, 403 subjects were selected by random sampling, including 145 men and 151 women aged 25-50 years and 57 men and 50 women over 50 years old in the framework of Tehran Lipid and Glucose Study (TLGS). MEASUREMENTS: Height, body weight, waist and hip circumferences were measured, and the body mass index (BMI) and waist-to-hip ratio (WHR) were calculated. Mean energy requirements for each sex-age group were estimated by multiplying specific coefficients (allocated to each group) by body weight and resting energy expenditure (REE), and the results of both methods were compared with mean energy values recommended by Food and Agriculture Organization (FAO)/World Health Organization (WHO) and the U.S. recommended dietary allowance (RDA). Dietary assessment was performed by 48-hour diet recall. A ratio of energy intake to basal metabolic rate lower than 1.27 was considered as under-reporting. Physical activity was evaluated by standard questionnaire of the Lipid Research Clinics (LRC). RESULTS: Women were significantly more overweight and obese than men (p < 0.001) and older women were more obese than younger ones (p < 0.05). Only one-third of the study population had adequate physical activity. Women had significantly lower physical activity than men (p < 0.01). Energy requirements for both age and sex groups were lower than recommended daily allowances for energy: men 25-50; 2576 vs. 2900; men > 50: 2155 vs. 2300; women 20-50: 2045 vs. 2200 and women > 50: 1817 vs. 1900 kilocalories (kcal). Reported energy intake of men was higher and that of women was lower than the RDA. Forty percent of women and 14% of men under-reported their energy intake. CONCLUSION: The energy requirement of the average Tehranian is lower than daily allowances; conditions of obesity and overweight are more prevalent in women. There is high frequency of under-reporting of energy intake in women. Lifestyle modifications to improve dietary habits and to increase physical activity are recommended to decrease overweight and obesity in urban population of Tehran.     

Cardiovascular and pulmonary risk factors in Berlin (West) schoolchildren: Findings of an exploratory study

In preparation for a comprehensive intervention project concerned with smoking behavior, physical activity, nutrition, and alcohol, an exploratory study of 800 public school and gymnasium pupils in the seventh and ninth grades (12–16 years old) was undertaken. The median of total serum cholesterol dropped from 4.8 mmol/liter in 12-year-old pupils to 4.2 mmol/liter in 16-year-olds. The decrease was greater in boys than in girls (0.7 versus 0.4 mmol/liter). The systolic and diastolic blood pressures rose slightly with age in boys and girls. The prevalence of occasional and daily smokers was 19.8 and 21%, respectively. The proportion of daily smokers was 36.4% among public school students (lower socioeconomic status) versus 4.1% among gymnasium pupils (higher socioeconomic status). Similar differences were found for the serum thiocyanate levels.     

Potato consumption and cardiovascular disease risk factors among Iranian population

Background: Previous studies investigated the effects of dietary glycaemic index and glycaemic load on cardiovascular risk factors. Little evidence is available regarding the association between potato intake and cardiovascular risk factors in Iran. Objective: This cross-sectional study was conducted in the first stage of Isfahan Healthy Heart Programme. Methods: A total of 4774 subjects were included in the present study. Dietary intake was assessed with a 49-item food frequency questionnaire. Biochemical assessments were done according to the standard protocol. Results: There were significant associations between potato consumption and diabetes mellitus (odds ratio (OR): 1.38; 95% CI: 1.14–1.67; p < 0.001), high fasting blood sugar level (OR: 1.40; 95% CI: 1.17–1.68; p < 0.001) and low serum high density lipoprotein level (OR: 1.10; 95% CI: 1.01–1.20; p = 0.02) remained after adjustments for possible confounding factors. Conclusion: We found a positive relation between potato consumption, high fasting blood glucose level and diabetes mellitus.     

A longitudinal study on glucose tolerance and other cardiovascular risk factors: associations within an elderly population.

From 1971 until 1975, 204 patients from a general practice, aged 64-87 at entry, were examined annually. At every examination body weight, serum lipids, and systolic blood pressure were measured, and a complete glucose tolerance test was carried out. Clinically diagnosed diabetics were excluded. Adjusted for age and sex, the annual change in the area under the glucose curve (AUC) was significantly associated with body weight change. Changes in serum total cholesterol, serum triglycerides, and systolic blood pressure were also associated with body weight change. The results were independent of potential confounders such as alcohol use, smoking habits, presence of cardiovascular disease, and baseline levels of the different risk factors. The change in AUC was also associated with changes in serum total cholesterol, independent of confounders such as body weight. Changes in AUC were not related to changes in systolic blood pressure and serum triglycerides. The results of this study suggest that changes in glucose tolerance are not only related to changes in body weight, but also to changes in serum cholesterol.     

Cardiovascular risk factors predicting all causes of death in an occupational population sample

A group of 768 men aged 40-59 at entry examination and belonging to an occupational sample of railroad employees in Rome have been examined for the measurement of some risk factors and followed-up for 20 years. In all 676 men, free from life-threatening diseases and with all measurements available, produced 166 fatal events in 20 years. Out of the 27 different personal characteristics considered only six contributed significantly to the multivariate prediction of all causes of death in the Cox proportional hazards computed by the forward stepwise technique. The factors predicting all causes of death were age, cigarette smoking, diabetes, blood pressure, mother's vital status and being on a diet prescribed by a doctor. The relative risk of those located in the upper decile of the estimated risk as compared to the bottom decile was 8.2. The results do not differ much from those obtained in a demographic sample studied in the same way.     

Associations between socioeconomic status and cardiovascular risk factors in an urban population in China

INTRODUCTION: In developed countries socioeconomic status has been proven to be an important factor in the progression of cardiovascular disease. The present article reports the results of a cross-sectional assessment to investigate the association between socioeconomic status and cardiovascular risk factors in a Chinese urban population. METHODS: In 1996, a behavioural risk factor survey was carried out in Tianjin, the third largest city in China. A sample of 4000 people aged 15-69 years, stratified by sex and 10-year age groups, was drawn randomly from urban areas of the city. The present study covers respondents aged 25-69 years (1615 men and 1592 women). Four socioeconomic indicators (education, occupation, income, and marital status), blood pressure, body mass index, and cigarette smoking were determined in the survey. RESULTS: Educational level seemed to be the most important measure of the four socioeconomic indicators in relation to the cardiovascular risk factors in the study population. People with lower socioeconomic status had higher levels of cardiovascular risk factors. The association between socioeconomic status and cardiovascular risk factors was more consistent among women than men. DISCUSSION: Our findings do not seem to differ from those observed in developed countries.     

Cardiovascular risk factors in Iranian adults according to educational levels: Isfahan healthy heart program

There is abundant evidence that the socioeconomic status (SES) is inversely associated with CVD risk factors. The objective of this study is to describe the distribution of CVD risk factors according to educational level in Iranian adults. A cross-sectional survey was performed on subjects over the age of 19 in three cities. Demographic data, as well as information on educational level and smoking habits was obtained and then height, weight and blood pressure measurement and blood sampling were arranged. Data was analyzed by the Mantel-Haenszel, Kendalls T correlation and multivariate analysis test. Of 9587 subjects, 48% were men and 52% were women, with mean ages of 39.0+/-15.3 and 38.8+/-14.5 years, respectively. All CVD risk factors showed an inverse relationship with educational level in all subjects, except for smoking and low HDL-C in women. High TC and LDL-C and low HDL-C were inversely related to educational level (P<0.05); however, this relationship was not significant with Mantel-Haenszel test in men. The association between CVD risk factors and educational level in women was stronger than in men. The differences found between CVD risk factors with educational level are important and should be considered in programs designed to increase level of education in order to lower CVD risk factors.     

Diabetes prediction,lipid accumulation product,and adiposity measures; 6-year follow-up: Tehran lipid and glucose study

Background

The body mass index (BMI) is the most commonly used marker for evaluating obesity related risks, however, central obesity measures have been proposed to be more informative. Lipid accumulation product (LAP) is an alternative continuous index of lipid accumulation, which is computed from waist circumference (WC, cm) and triglycerides (TGs, mmol/l): (WC-65) ×TG (men) and (WC-58) ×TG (women). We sought in this study to assess if LAP can outperform BMI, waist-to-height-ratio (WHtR), or waist-to-hip-ratio (WHpR) in identifying prevalent and predicting incident diabetes.

Results

The cross-sectional analyses were performed on a sample included 3,682 men and 4,989 women who were not pregnant, aged ≥ 20 years. According to the age (≥ 50 and <50 years) - and sex-specific analyses, odds ratios (ORs) of LAP for prevalent diabetes were higher than those of BMI, WHpR, or WHtR among women, after adjustment for mean arterial pressure and family history of diabetes. The OR of LAP in old men was lower than those of other adiposity measures; in young men, however, LAP was superior to BMI but identical to WHpR and WHtR in identifying prevalent diabetes. Except in young men, LAP showed highest area under the receiver operating characteristic curves (AROC) for prevalent diabetes (P for trend ≤ 0.005).For longitudinal analyses, a total of 5,018 non-diabetic subjects were followed for ~6 years. The ORs of BMI, WHpR, and WHtR were the same as those of LAP in both sexes and across age groups; except in young men where LAP was superior to the BMI. AROCs of LAP were relatively the same as anthropometric adiposity measures.

Conclusions

LAP was a strong predictor of diabetes and in young individuals had better predictability than did BMI; it was, however, similar to WHpR and WHtR in prediction of incident diabetes.

     

Neurodevelopmental outcome and risk factors for impaired development of African American infants in an underserved urban population: a population-based study

We aimed 1) to define risk factors for adverse outcome in urban African American patients, 2) to determine whether clinical variables as risk factors are congruent with previously published data, and 3) to identify the proportion of infants with different outcomes. The study included African American infants who were born and participated in neurodevelopmental follow-up. Infants with gestational age range of 23 to 41 weeks, and birth weight (BW) range of 495 to 3,965 g were classified by developmental outcome. Among the smallest infants, BW, gestational age, gender and respiratory distress syndrome were significantly (p<.05) associated with adverse outcome. No significant risk factors were identified for adverse outcome in the two other birth weight categories. Adverse outcomes were seen more frequently in infants with BW ≤1,500 g than in larger infants. The number of infants with severe outcome was found higher than previously reported and may be related to different racial/generational origin.     

Epidemiological study of coronary artery disease and its risk factors in an elderly urban population of north India.

In view of the rapid increase in the prevalence of coronary artery disease (CAD) in developing countries, our aim was to determine the prevalence of CAD and its risk factors and lifestyle factors in an elderly population from north India.

A random sample of 595 elderly subjects between 50 to 84 years of age was obtained from the urban population of Moradabad. The response rate was 90.1%. The survey methods included a questionnaire containing information on 7-day food intake, other lifestyle factors, Rose questionnaire for diagnosis of angina pectoris, a standard 12-lead electrocardiogram, blood pressure measurements and blood examination.

The total prevalence of CAD based on clinical history and electrocardiogram was 121/1000 (95% CI 72 to 165). The prevalence rate was slightly higher in males (130/1000) than in females (110/1000). The prevalence of CAD based on the Rose questionnaire was 57/1000 and based on electrocardiogram in 561 asymptomatic subjects was 67/1000. CAD was significantly higher in the elderly (65 to 84 years) group than in the middle-aged (50 to 64 years) group (168 vs. 97 per 1000), respectively. While the prevalence of hypertension was significantly higher in the elderly than middle-aged group respectively (214 vs. 168 per 1000), the prevalence of central obesity was significantly higher in the middle-aged than elderly group (674 vs. 632 per 1000). Other risk factors including smoking were comparable in the two subgroups. Prevalence of major risk factors and central obesity were significantly higher among patients with CAD than in the rest of the subjects. Prevalence of CAD was significantly higher in the middle and higher socio-economic groups compared to the lower income group. These higher income groups were also eating significantly higher amounts of visible fat and had a higher prevalence of physical inactivity (93.3%) compared to the lower income group.

CAD and its risk factors such as hypertension, hypercholesterolemia, diabetes and central obesity are of sufficient magnitude in the elderly population of India to be a major public health problem. The findings also indicate that CAD is more commonly associated with middle and higher socio-economic status which may be due to greater consumption of dietary fat and more sedentariness compared to lower socioeconomic groups.