National and subnational mortality effects of metabolic risk factors and smoking in Iran: a comparative risk assessment

<p>Abstract</p> <p>Background</p> <p>Mortality from cardiovascular and other chronic diseases has increased in Iran. Our aim was to estimate the effects of smoking and high systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC), and high body mass index (BMI) on mortality and life expectancy, nationally and subnationally, using representative data and comparable methods.</p> <p>Methods</p> <p>We used data from the Non-Communicable Disease Surveillance Survey to estimate means and standard deviations for the metabolic risk factors, nationally and by region. Lung cancer mortality was used to measure cumulative exposure to smoking. We used data from the death registration system to estimate age-, sex-, and disease-specific numbers of deaths in 2005, adjusted for incompleteness using demographic methods. We used systematic reviews and meta-analyses of epidemiologic studies to obtain the effect of risk factors on disease-specific mortality. We estimated deaths and life expectancy loss attributable to risk factors using the comparative risk assessment framework.</p> <p>Results</p> <p>In 2005, high SBP was responsible for 41,000 (95% uncertainty interval: 38,000, 44,000) deaths in men and 39,000 (36,000, 42,000) deaths in women in Iran. High FPG, BMI, and TC were responsible for about one-third to one-half of deaths attributable to SBP in men and/or women. Smoking was responsible for 9,000 deaths among men and 2,000 among women. If SBP were reduced to optimal levels, life expectancy at birth would increase by 3.2 years (2.6, 3.9) and 4.1 years (3.2, 4.9) in men and women, respectively; the life expectancy gains ranged from 1.1 to 1.8 years for TC, BMI, and FPG. SBP was also responsible for the largest number of deaths in every region, with age-standardized attributable mortality ranging from 257 to 333 deaths per 100,000 adults in different regions.</p> <p>Discussion</p> <p>Management of blood pressure through diet, lifestyle, and pharmacological interventions should be a priority in Iran. Interventions for other metabolic risk factors and smoking can also improve population health.</p

Monogenic Primary Immunodeficiency Disorder Associated with Common Variable Immunodeficiency and Autoimmunity

Background: Common variable immunodeficiency (CVID) is the most frequent primary immunodeficiency disorder mainly characterized by recurrent bacterial infections besides other immunological defects including loss of or dysfunction of B cells and decreased immunoglobulin levels. In this study, our aim is to evaluate clinical, immunological, and molecular data of patients with a primary clinical diagnosis of CVID and autoimmune phenotype with a confirmed genetic diagnosis. Methods: Among 297 patients with CVID, who were registered in the Iranian Primary Immunodeficiency Registry at Children's Medical Center Hospital in Iran, 83 patients have been genetically examined and 27 patients with autoimmunity and confirmed genetic mutations were selected for analysis. Whole-exome sequencing and confirmatory Sanger sequencing methods were used for the study population. A questionnaire was retrospectively filled for all patients to evaluate demographic, laboratory, clinical, and genetic data. Results: In the 27 studied patients, 11 different genetic defects were identified, and the most common mutated gene was LRBA, reported in 17 (63.0) patients. Two patients (7.7) showed autoimmune complications as the first presentation of immunodeficiency. Eleven patients (40.7) developed one type of autoimmunity, and 16 patients (59.3) progressed to poly-autoimmunity. Most of the patients with mono-autoimmunity (n = 9, 90.0) primarily developed infectious complications, while in patients with poly-autoimmunity, the most common first presentation was enteropathy (n = 6, 37.6). In 13 patients (61.9), the diagnosis of autoimmune disorders preceded the diagnosis of primary immunodeficiency. The most frequent autoimmune manifestations were hematologic (40.7), gastrointestinal (48.1), rheumatologic (25.9), and dermatologic (22.2) disorders. Patients with poly-autoimmunity had lower regulatory T cells than patients with mono-autoimmunity. Conclusion: In our cohort, the diagnosis of autoimmune disorders preceded the diagnosis of primary immunodeficiency in most patients. This association highlights the fact that patients referring with autoimmune manifestations should be evaluated for humoral immunity. © 2020 Georg Thieme Verlag. All rights reserved

Hypertension Prevention and Control Program

&quot;nTo control hypertension in Iran, one of the most preventable diseases, a program was established in rural areas of the coun&amp;shy;try, employing the main strategy of people screening aged 30 years old and above, confirmation of suspected cases, offering ca&amp;shy;res and follows up. This program is integrated in the primary health care system at rural areas. An evaluation system embed&amp;shy;ded in the program, helps collecting data on main variable defined, including new cases and care taken. According to the results, the defects of the program are mainly categorized as education and referral system accessibility

Effect of long-term exposure to ambient particulate matter on prevalence of type 2 diabetes and hypertension in Iranian adults: an ecologic study

Air pollution is considered as an environmental risk to health worldwide. Current evidence is mostly from Western populations exposed to lower levels of pollutants. This study was to explore the association of type 2 diabetes (T2D) and hypertension prevalence with exposure to high levels of air pollution in Iranian adults. The air pollution data were obtained from the air quality monitoring stations of five large cities in Iran from 2006 to 2011. The air quality monitoring stations could only detect ambient particulate matter₁₀ (PM10) during the study period; therefore, the average PM10 concentration was considered for comparison. We grouped the cities as group 1 (Tehran, Shiraz) with PM10 concentration &lt; 100 μg/m3, and group 2 (Kermanshah, Ahwaz, Esfahan) with PM10 concentration &gt; 100 μg/m3. Data from the Surveillance of Risk Factors of Non-Communicable Disease (SuRFNCD) study were used to calculate the prevalence of T2D and hypertension. We assessed the association between air pollution and the prevalence of T2D using logistic regression models. Odds ratios (ORs) with 95 CI for each outcome were calculated after adjusting for age, sex, BMI, physical activity, and other covariates. The 5-year average of PM10 concentration was higher in group 2 (120.15 ± 6.81 μg/m3) compared to group 1 (83.95 ± 7.81 μg/m3). The prevalence of T2D in group 2 was 13.8, while it was 10.7 in group 1 (p = 0.01), OR = 1.32 (95 CI 1.03â��1.69). Similarly, hypertension was more prevalent in group 2 (15.7 vs. 11.9, p = 0.005, OR = 1.55, 95 CI 1.20â��1.99). PM10 is associated with higher prevalence of T2D and hypertension in Iranian adults. © 2017, Springer-Verlag GmbH Germany

Effect of long-term exposure to ambient particulate matter on prevalence of type 2 diabetes and hypertension in Iranian adults: an ecologic study

Air pollution is considered as an environmental risk to health worldwide. Current evidence is mostly from Western populations exposed to lower levels of pollutants. This study was to explore the association of type 2 diabetes (T2D) and hypertension prevalence with exposure to high levels of air pollution in Iranian adults. The air pollution data were obtained from the air quality monitoring stations of five large cities in Iran from 2006 to 2011. The air quality monitoring stations could only detect ambient particulate matter₁₀ (PM10) during the study period; therefore, the average PM10 concentration was considered for comparison. We grouped the cities as group 1 (Tehran, Shiraz) with PM10 concentration &lt; 100 μg/m3, and group 2 (Kermanshah, Ahwaz, Esfahan) with PM10 concentration &gt; 100 μg/m3. Data from the Surveillance of Risk Factors of Non-Communicable Disease (SuRFNCD) study were used to calculate the prevalence of T2D and hypertension. We assessed the association between air pollution and the prevalence of T2D using logistic regression models. Odds ratios (ORs) with 95 CI for each outcome were calculated after adjusting for age, sex, BMI, physical activity, and other covariates. The 5-year average of PM10 concentration was higher in group 2 (120.15 ± 6.81 μg/m3) compared to group 1 (83.95 ± 7.81 μg/m3). The prevalence of T2D in group 2 was 13.8, while it was 10.7 in group 1 (p = 0.01), OR = 1.32 (95 CI 1.03â��1.69). Similarly, hypertension was more prevalent in group 2 (15.7 vs. 11.9, p = 0.005, OR = 1.55, 95 CI 1.20â��1.99). PM10 is associated with higher prevalence of T2D and hypertension in Iranian adults. © 2017, Springer-Verlag GmbH Germany

Prevalence of metabolic syndrome and its components in the Iranian adult population: A systematic review and meta-analysis

Context: Metabolic syndrome (MetS) increases the risk of most non-communicable diseases; gathering information about its prevalence can be very effective in formulating preventive strategies for metabolic diseases. There are many different studies about the prevalence of MetS in Iran, but the results and the study populations of these studies are very different; therefore, it is very important to have an overall estimation of its prevalence in Iran. Objectives: This study systematically reviewed the findings of all available studies on MetS in the adult Iranian population and estimated the overall prevalence of MetS in this population. Data Sources: International databases (Scopus, ISI Web of Science, and PubMed) were searched for papers published from January, 2000 to December, 2013 using medical subject headings (MeSH), Emtree, and related keywords (metabolic syndrome, dysmetabolic syndrome, cardiovascular syndrome, and insulin resistance syndrome) combined with the words "prevalence" and "Iran." The Farsi equivalent of these terms and all probable combinations were used to search Persian national databases (IranMedex, Magiran, SID, and Irandoc). Study Selection: All population-based studies and national surveys that reported the prevalence of MetS in healthy Iranian adults were included. Data Extraction: After quality assessment, data were extracted according to a standard protocol. Because of between-study heterogeneity, data were analyzed by the random effect method. Results: We recruited the data of 27 local studies and one national study. The overall estimation of MetS prevalence was 36.9 (95 CI: 32.7 - 41.2) based on the Adult Treatment Panel III (ATP III) criteria, 34.6 (95 CI: 31.7 - 37.6) according to the International Diabetes Federation (IDF), and 41.5 (95 CI: 29.8 - 53.2) based on the Joint Interim Societies (JIS) criteria. The prevalence of MetS determined by JIS was significantly higher than those determined by ATP III and IDF. The prevalence of MetS was 15.4 lower in men than in women (27.7 versus 43.1) based on the ATP III criteria, and it was 11.3 lower in men based on the IDF criteria; however according to the JIS criteria, it was 8.4 more prevalent in men. Conclusions: There is a high prevalence of MetS in the Iranian adult population, with large variations based on different measurement criteria. Therefore, prevention and control of MetS should be considered a priority. © 2015, Iranian Red Crescent Medical Journal

Surface layer self diffusion in icosahedral Al-Pd-Mn quasicrystals

The self diffusion of Mn and Pd in a single grain icosahedral Al₆₉.₉Pd₂₀.₅Mn₉.₆ quasicrystal has been determined by low energy ion scattering (LEIS). The diffusion was determined by depositing different elements (Pd, Mn) on the surface and measuring the rate of change in surface composition as a function of temperature by LEIS. The surface composition was monitored over the temperature range of 355–575 K for Mn and 440–745 K for Pd and compared to model calculations to allow the activation energy for diffusion to be determined. Activation energies of 0.20 ± 0.01 eV for Mn and 0.64 ± 0.03 eV for Pd have then been measured for self diffusion in i-Al–Pd–Mn, respectively. No deviation from Arrhenius behavior was detected in the temperature range covered by the present experiments. From the low values of activation energy we propose that this range of diffusion is phason related, reflecting the specific nature of the icosahedral structure