main data for fasting plasma glucose change

main data for fasting plasma glucose chang

Additional file 1 of The impact of obesity on different glucose tolerance status with incident cardiovascular disease and mortality events over 15 years of follow-up: a pooled cohort analysis

Additional file 1: Table S1. Baseline characteristics of subjects, stratified by study and gender. Fig S1. Study Flowchart CV Cardiovascular, ARIC Atherosclerosis Risk in Communities, MESA Multi-Ethnic Study of Atherosclerosis, TLGS Tehran Lipid and Glucose Study. Fig S2. The annual incidence rates of cardiovascular disease (CVD) by diabesity phenotypes in men and women, separately. Normoglycemia: FPG<100 mg/dl & no medication; pre-diabetes: FPG 100-126 mg/dl and no medication; type 2 diabetes; FPG ≥126 mg/dl or using medication. Obesity (BMI≥30 kg/m2). Fig S3. The annual incidence rates of cardiovascular (CV) mortality by diabesity phenotypes in men and women, separately. Normoglycemia: FPG<100 mg/dl & no medication; pre-diabetes: FPG 100-126 mg/dl and no medication; type 2 diabetes; FPG ≥126 mg/dl or using medication. Obesity (BMI≥30 kg/m2). Fig S4. The annual incidence rates of all-cause mortality by diabesity phenotypes in men and women, separately. Normoglycemia: FPG<100 mg/dl & no medication; pre-diabetes: FPG 100-126 mg/dl and no medication; type 2 diabetes; FPG ≥126 mg/dl or using medication. General obesity (BMI≥30 kg/m2)

Incidence and risk factors of isolated systolic and diastolic hypertension: a 10 year follow-up of the Tehran Lipids and Glucose Study

<div><p></p><p>The objective of this study is to examine the incidence and risk factors of isolated systolic hypertension (ISH) and isolated diastolic hypertension (IDH) in a Middle Eastern population, during a median follow-up of 9.6 years. In total, 8573 subjects without hypertension, cardiovascular disease and known diabetes were recruited into the study. To calculate the incidence of ISH, those with diastolic blood pressure (DBP) ≥ 90 mmHg during follow-up, and for calculating IDH those with systolic blood pressure (SBP) ≥ 140 mmHg during follow-up, were excluded. During follow-up, 235 new cases of ISH were identified, with a crude incidence rate of 5.7/1000 person-years; the corresponding values for IDH were 470 and 10.9/1000 person-years. Using backward stepwise Cox regression analysis, older age, baseline SBP and body mass index were related to incident ISH. Regarding IDH, younger age, baseline DBP and waist circumference were associated with higher risk, whereas female gender and being married were associated with lower risk (all <i>p</i> < 0.05). The C-statistics for the prediction model were 0.91 for ISH and 0.76 for IDH. In conclusion, after a decade of follow-up of this Iranian population, we found an incidence of about 0.5% and 1% per year for ISH and IDH, respectively.</p></div

sub-study sample for fasting plasma change

sub-study sample for fasting plasma chang

The association between changes in blood pressure components and incident cardiovascular diseases

<p><b>Purpose:</b> To determine the association of changes in blood pressure (BP) components between baseline examination (1999–2001) and a second visit (2002–2005) with incident cardiovascular diseases (CVD).</p> <p><b>Methods:</b> In 3569 (2048 female) Iranian subjects ≥30 y, systolic BP, diastolic BP, mean arterial pressure (MAP) and pulse pressure (PP) were evaluated in two consecutive visits. Subjects were then followed for cardiovascular events. Multivariate sex-adjusted Cox Proportional-Hazards models were built for each BP component’s change, and further adjusted for baseline BP values, traditional cardiovascular risk factors, and their changes.</p> <p><b>Results:</b> During a median follow-up of 6.09 years after the second examination, 303 CVD cases occurred. A 1 SD increase in systolic BP, diastolic BP and MAP were significantly associated with 21%, 22%, and 95% increased CVD risk after adjustments for baseline values of BP components and other common risk factors (all <i>p</i>-values <0.05). Importantly, diastolic BP change resisted after further adjustment with systolic BP change (hazard ratio 1.21, CI 95% 1.05–1.39). PP change showed no significant association with CVD.</p> <p><b>Conclusions:</b> In a middle-aged population, three-year rises in systolic BP, diastolic BP, MAP, but not PP were associated with increased incident CVD. The significant association between diastolic BP change and CVD was shown independent of systolic BP change.</p

Additional file 1: Table S1. of Predictors of early adulthood hypertension during adolescence: a population-based cohort study

Odds Ratios (95% CIs) of significant variables in adolescence for hypertension events in adulthood, considering BMI as anthropometric variable. Table S2. Odds Ratios (95% CIs) of significant variables in adolescence for hypertension events in adulthood, considering waist circumference as anthropometric variable. Table S3. Odds Ratios (95% CIs) of significant variables in adolescence for hypertension events in adulthood, considering hip circumference as anthropometric variable. (DOCX 16 kb

Additional file 1: Table S1. of Divergent pathway of lipid profile components for cardiovascular disease and mortality events: Results of over a decade follow-up among Iranian population

cardiovascular disease event incidence (per 1000 person-year) of different serum lipid markers and lipid indices among men, women and total participants (n=5054); Tehran Lipid and Glucose Study (TLGS) (2001-2012). Table S2 cardiovascular mortality rate (per 1000 person-year) of different serum lipid markers and lipid indices among total participants (n=5518); Tehran Lipid and Glucose Study (TLGS) (2001-2012). Table S3 Non-cardiovascular mortality rate (per 1000 person-year) of different serum lipid markers and lipid indices among total participants (n=5518); Tehran Lipid and Glucose Study (TLGS) (2001-2012). Table S4 Hazard ratios of lipid measures for predicting first cardiovascular disease events among participants without prevalent CVD in those with available data on HOMA-IR (n=1548); Tehran Lipid and Glucose Study (TLGS) (2001-2012)*. Table S5 Hazard ratios of lipid measures for predicting first cardiovascular disease events among participants without prevalent CVD based on lipid profile tertiles CVD in those with available data on HOMA-IR (n=1548); Tehran Lipid and Glucose Study (TLGS) (2001-2012). (DOCX 65 kb

Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

BackgroundRegularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels.MethodsWe applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level.FindingsIn 2019, there were 12·2 million (95% UI 11·0-13·6) incident cases of stroke, 101 million (93·2-111) prevalent cases of stroke, 143 million (133-153) DALYs due to stroke, and 6·55 million (6·00-7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8-12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1-6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0-73·0), prevalent strokes increased by 85·0% (83·0-88·0), deaths from stroke increased by 43·0% (31·0-55·0), and DALYs due to stroke increased by 32·0% (22·0-42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0-18·0), mortality decreased by 36·0% (31·0-42·0), prevalence decreased by 6·0% (5·0-7·0), and DALYs decreased by 36·0% (31·0-42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0-24·0) and incidence rates increased by 15·0% (12·0-18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5-3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5-3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57-8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97-3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01-1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7-90·8] DALYs or 55·5% [48·2-62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3-48·6] DALYs or 24·3% [15·7-33·2]), high fasting plasma glucose (28·9 million [19·8-41·5] DALYs or 20·2% [13·8-29·1]), ambient particulate matter pollution (28·7 million [23·4-33·4] DALYs or 20·1% [16·6-23·0]), and smoking (25·3 million [22·6-28·2] DALYs or 17·6% [16·4-19·0]).InterpretationThe annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.FundingBill & Melinda Gates Foundation

Diabetes mortality and trends before 25 years of age: an analysis of the Global Burden of Disease Study 2019

Background: Diabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods: We used estimates of GBD 2019 to calculate international diabetes mortality at ages younger than 25 years in 1990 and 2019. Data sources for causes of death were obtained from vital registration systems, verbal autopsies, and other surveillance systems for 1990–2019. We estimated death rates for each location using the GBD Cause of Death Ensemble model. We analysed the association of age-standardised death rates per 100 000 population with the Socio-demographic Index (SDI) and a measure of universal health coverage (UHC) and described the variability within SDI quintiles. We present estimates with their 95% uncertainty intervals. Findings: In 2019, 16 300 (95% uncertainty interval 14 200 to 18 900) global deaths due to diabetes (type 1 and 2 combined) occurred in people younger than 25 years and 73·7% (68·3 to 77·4) were classified as due to type 1 diabetes. The age-standardised death rate was 0·50 (0·44 to 0·58) per 100 000 population, and 15 900 (97·5%) of these deaths occurred in low to high-middle SDI countries. The rate was 0·13 (0·12 to 0·14) per 100 000 population in the high SDI quintile, 0·60 (0·51 to 0·70) per 100 000 population in the low-middle SDI quintile, and 0·71 (0·60 to 0·86) per 100 000 population in the low SDI quintile. Within SDI quintiles, we observed large variability in rates across countries, in part explained by the extent of UHC (r2=0·62). From 1990 to 2019, age-standardised death rates decreased globally by 17·0% (−28·4 to −2·9) for all diabetes, and by 21·0% (–33·0 to −5·9) when considering only type 1 diabetes. However, the low SDI quintile had the lowest decline for both all diabetes (−13·6% [–28·4 to 3·4]) and for type 1 diabetes (−13·6% [–29·3 to 8·9]). Interpretation: Decreasing diabetes mortality at ages younger than 25 years remains an important challenge, especially in low and low-middle SDI countries. Inadequate diagnosis and treatment of diabetes is likely to be major contributor to these early deaths, highlighting the urgent need to provide better access to insulin and basic diabetes education and care. This mortality metric, derived from readily available and frequently updated GBD data, can help to monitor preventable diabetes-related deaths over time globally, aligned with the UN's Sustainable Development Targets, and serve as an indicator of the adequacy of basic diabetes care for type 1 and type 2 diabetes across nations. Funding: Bill & Melinda Gates Foundation

Mapping routine measles vaccination in low- and middle-income countries

The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs)1–4. Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19)5–8. Here we generated annual estimates of routine childhood MCV1 coverage at 5 × 5-km2 pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations; strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children