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Papers by Anita Eftekharzadeh

Research paper thumbnail of Decomposition of socioeconomic inequality in COVID‐19 mortality in Iran: A retrospective cohort study

Health & Social Care in The Community, Nov 5, 2021

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Research paper thumbnail of Predictors of incident obesity phenotype in nonobese healthy adults

European Journal of Clinical Investigation, Apr 5, 2017

Background: Despite their different cardiovascular consequences, little is known about predictors... more Background: Despite their different cardiovascular consequences, little is known about predictors of metabolically healthy (MHO) and metabolically unhealthy (MUHO) obesity. This cohort study was designed to address this question in participants of the Tehran Lipid and Glucose Study. Materials and methods: Employing the Joint Interim Statement (JIS) metabolic syndrome criteria to define MHO/MUHO phenotypes, non-obese, otherwise healthy individuals, aged >20 years (n= 3489) were recruited and followed up for a median of 13.4 years. Results: At the follow up, MHO incidence rate in obese individuals was 36.6%. Comparing MHO vs. MUHO, female gender (odds ratio (OR)=3.28, 95% confidence interval (CI) 1.27, 8.46)), increased body mass index (BMI) (OR=1.32, 95% CI 1.12, 1.60) and elevated high This article is protected by copyright. All rights reserved. density lipoprotein-cholesterol (HDL-C) levels (OR=1.04, 95% CI 1.02, 1.07) were related to higher odds of incident MHO, while older age (OR=0.95, 95% CI 0.92, 0.98), increased waist circumference (WC) (OR=0.86, 95% CI 0.81, 0.91), higher WC gain (OR=0.91, 95% CI 0.87, 0.95) and increased diastolic blood pressure (DBP) (OR=0.94, 95% CI 0.91, 0.98) prevented progression toward MHO. Conclusions: While baseline BMI and WC were detrimental for developing MHO vs. MUHO, gender was the strongest predictor of incident obesity phenotype in healthy non-obese individuals.

Research paper thumbnail of A Bibliometric Study of Scientific Literature on Obesity Research in Web of Science Database (2008-2020): Evidence from the MENA Region

Iranian journal of public health, May 22, 2023

Background: Obesity has increasingly become a health threat in the Middle East and North Africa (... more Background: Obesity has increasingly become a health threat in the Middle East and North Africa (MENA) countries. This study aimed to investigate the scientific publications on obesity in the MENA countries during 2008-2020. Methods: A longitudinal analysis of 13 years (2008-2020) of bibliographic data from obesity-related articles was performed. Web of Science core collection (WoS) was searched for bibliographic data. The bibliometric indicators including overall productivity and collaboration along with the prevalence of obesity and socioeconomic status were used to assess and compare the context of obesity research efforts in the MENA region. Results: The overall obesity-related articles of the MENA countries cumulated to 23680 publications. The MENA region accounted for a 6.5% global publication share in obesity research. Turkey contributed the highest rate of total publications (n=6162) followed by Iran (n=5302) and Israel (n=2847). Iran and Turkey had the lowest rates of international collaborations. The overall obesity research was not significantly associated with socio-demographic index (SDI) measure (r=-0.26, P=0.27). No significant association was found between Gross National Income (GNI) per capita and the overall production of obesity research (r=0.41, P=0.08). Additionally, obesity research was not significantly associated with the prevalence of obesity in the countries (r=0.24, P=0.30). Conclusion: This study observed an increased share of scientific productivity in the field of obesity from the MENA countries. Neither SDI, GNI per capita, nor obesity prevalence was not significantly associated with the overall productivity of the region.

Research paper thumbnail of Association between sleep duration and nephropathy in patients with type II diabetes mellitus

International Journal of Diabetes in Developing Countries, Jan 23, 2018

Sleep disturbances have been shown to be associated with adverse health outcomes including diabet... more Sleep disturbances have been shown to be associated with adverse health outcomes including diabetes mellitus (DM), hypertension, and obesity. However, little is known about the relationship between sleep duration and diabetes complications. The present cross-sectional study aimed to examine the association between sleep duration and nephropathy in a population of type 2 DM patients. Diabetic patients aged ≥ 18 years who visited two outpatient clinics in Kermanshah from February 2014 to February 2015 entered the study. Demographic, anthropometric, and biochemical data, as well as information on sleep duration of participants within the past 4 weeks, were collected by an interviewer. Patients with estimated glomerular filtration rate (eGFR) ≤ 60 ml/24 h were excluded from the study. Proteinuria was defined as excretion of more than 150 mg protein in 24-h urine. Differences in urine protein and related variables were examined between four sleep duration groups (≤ 5, 6, 7, and ≥ 8 h). Linear and logistic regression analyses were employed to assess the association between sleep duration and diabetic nephropathy. Four hundred thirty-two patients (63.8% female) with a mean age of 54.68 ± 9.98 years were analyzed. There were statistically significant differences in age, body mass index, waist circumference, DM duration, HbA1C, total cholesterol, HDL cholesterol, triglyceride, uric acid, and urine protein between sleep duration groups. While adjusted linear regression showed no association between sleep duration and urine protein (p = 0.300), multivariable logistic regression revealed male gender, increased HbA1C, shorter sleep duration, increased DM duration, lower eGFR, higher DBP, decreased HDL-C, and higher uric acid levels to be statistically associated with proteinuria. Short sleep duration is adversely associated with proteinuria in type 2 DM patients with normal and near-normal kidney function.

Research paper thumbnail of Instability of different adolescent metabolic syndrome definitions tracked into early adulthood metabolic syndrome: Tehran Lipid and Glucose Study (TLGS)

Pediatric Diabetes, Jan 30, 2016

There are substantial controversies about the clinical utility of adolescent metabolic syndrome (... more There are substantial controversies about the clinical utility of adolescent metabolic syndrome (MetS). The current study examined the stability of adolescent MetS by assessing the agreement and discriminative abilities of four different definitions of adolescent MetS and the adult MetS definition during a 10.4-yr follow up. For this study, 1424 adolescents (55.2% female), who participated in the framework of the Tehran Lipid and Glucose Study were included. Kappa was calculated for agreement between adolescent MetS definitions [Cook, de Ferranti, pediatric National Cholesterol Education Program (NCEP) and pediatric International Diabetes Federation (IDF)] and the adulthood MetS definition defined by the joint interim statement (JIS) criteria. MetS persistence, instability, and incidence were assessed, and for each of the four adolescent definitions, sensitivity, specificity, and area under receiver operating curve (AUC) for the counting of categorical adulthood MetS components was evaluated. The agreement between the four adolescent MetS definitions and JIS was poor (κ = 0.094-0.255). All definitions showed low sensitivity and high specificity, except for de Ferranti's, which contrary to other definitions, had higher sensitivity and lower specificity. All four adolescent definitions revealed generally low AUCs (0.601-0.647). Compared with the pubertal group (11-14 yr), the predictive power was slightly higher in the late-pubertal group (15-18 yr). Cook's and de Ferranti's definitions showed fairly better predictive powers (0.647 and 0.644, respectively). Across all definitions, instability ranged between 5.4 and 19.6%. The adolescent definitions show considerable amount of instability defined as poor agreement and low discriminative abilities tracked into early adulthood.

Research paper thumbnail of The Association Between Subclinical Hypothyroidism and Metabolic Syndrome as Defined by the ATP III Criteria

Metabolic Syndrome and Related Disorders, Apr 1, 2016

The association between subclinical hypothyroidism (SCH) and metabolic syndrome (MetS) is a matte... more The association between subclinical hypothyroidism (SCH) and metabolic syndrome (MetS) is a matter of debate. In this study, we aimed to examine the risk of MetS in SCH through a systematic review and meta-analysis. A systematic search of published literature up to September 2015 was conducted. General population studies were included if they had considered SCH as the independent variable. After data extraction, a meta-analysis was run to assess the odds ratio (OR) of MetS and its components between subclinical hypothyroid and euthyroid groups. Only studies employing Adult Treatment Panel III (ATP III) criteria for MetS were included in the meta-analysis. In the SCH group, female gender was more prevalent [OR = 1.65, 95% confidence interval (95% CI) 1.29-2.13]. Meta-analysis showed no significant difference in MetS prevalence between SCH and euthyroid individuals (OR = 1.13, 95% CI 0.95-1.34). However, the prevalence of central obesity (OR = 1.43, 95% CI 1.04-1.96) was significantly higher in the SCH group. On the other hand, hypertriglyceridemia was more prevalent in the female-only SCH subgroup. In conclusion, although we found some MetS components to be more prevalent in SCH, the prevalence of MetS as defined by ATP III criteria was not increased in SCH. Considerable heterogeneity observed may have influenced the results on MetS components.

Research paper thumbnail of Association between serum uric acid and proteinuria in patients with type 2 diabetes and stages 1 and 2 chronic kidney disease

Clinical Epidemiology and Global Health, Mar 1, 2020

Background:-Interaction between serum uric acid level and diabetic nephropathy is a matter of deb... more Background:-Interaction between serum uric acid level and diabetic nephropathy is a matter of debate. This study is designed to examine the association between serum uric acid (SUA) level and proteinuria in in type 2 diabetes patients with stages 1 and 2 chronic kidney disease (CKD). Material and methods:-For this cross-sectional study, type 2 diabetic patients aged ≥ 20 years were recruited from two clinics in Kermanshah city from February 2014 to February 2016. Demographic, anthropometric and metabolic data of participants were obtained. Male and female participants were analyzed separately by logistic regression. Results:-A total of 432 patients (63.7% women) with a mean ± standard deviation (SD) age of 54.68 ± 9.96 years were analyzed. Multivariate logistic regression model including age, diabetes duration, body mass index (BMI), estimated glomerular filtration rate (eGFR), fasting blood glucose (FBS), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and SUA showed that in male participants, SUA, FBS, DBP and eGFR significantly predicted proteinuria, while in female gender, SUA, HDL-C, DM duration and age were the independent correlates of proteinuria. Conclusions:-Serum uric acid significantly predicted proteinuria in both genders. Moreover, in women with type 2 diabetes and stages 1 and 2 CKD, while the association between eGFR and proteinuria was lost, serum uric acid level was independently correlated with the presence of proteinuria.

Research paper thumbnail of National and Regional Fraction of Cancer Incidence and Death Attributable to Current Tobacco and Water-Pipe Smoking in the Eastern Mediterranean Countries in 2020

Nicotine & Tobacco Research

Introduction We aimed to calculate the Population Attributable Fraction (PAF) of cancers due to t... more Introduction We aimed to calculate the Population Attributable Fraction (PAF) of cancers due to tobacco use in the Eastern Mediterranean Region (EMRO), where water-pipe smoking is prevalent but its effect was not considered in previous studies. Aims and Methods We applied Levin’s formula to estimate PAFs of cancers due to tobacco use (defined as all type tobacco including both cigarette and water-pipe). We also calculated PAF of water-pipe smoking separately. Exposure prevalence data were retrieved from representative national and subnational surveys. Data on cancer incidence and death were also and cancer cases were obtained GLOBOCAN 2020. We also obtained associated relative risks from published meta-analyses. Results Of the total 715 658 incident adult cancer cases that were reported in 2020 in EMRO, 14.6% (n = 104 800) was attributable to tobacco smoking (26.9% [n = 92 753]) in men versus 3.3% (n = 12 048) in women. Further, 1.0% of incident adult cancers were attributable to cu...

Research paper thumbnail of Preliminary report on the efficacy of Melodic Intonation Therapy in Persian aphasic patients

Iranian Journal of Medical Sciences, 2000

Research paper thumbnail of rRT-PCR Test Results Upon Admission Might Be Associated with Outcome in Hospitalized Chest CT-Positive COVID-19 Patients: A Provincial Retrospective Cohort with Active Follow-Up

SSRN Electronic Journal, 2020

Background: The Covid-19 pandemic imposed the most devastating challenge on healthcare systems wo... more Background: The Covid-19 pandemic imposed the most devastating challenge on healthcare systems worldwide. Iran was among the first countries that had to confront serious shortages in RT-PCR testing for SARS-CoV-2 and ventilators availabilities amid the COVID-19 outbreak. This study aimed to investigate the clinical course of hospitalized COVID-19 patients with different rRT-PCR test results during the first 3 weeks of the outbreak in Qazvin province, Iran. Methods: Data of hospitalized patients primarily diagnosed as having COVID-19 in all 12 centers across the whole Qazvin province during Feb 20-Mar 11, 2020 was analyzed for this retrospective cohort study. A multivariate logistic regression model was applied to assess the independent associates of death among COVID-19 patients. Findings: 998 patients (57% male, median age 54 years) with positive chest CT-scan changes were included in this study. Among them, 558 patients were examined with rRT-PCR test and 73·8% tested positive. Case fatality rate was 20·68% and 7·53% among test-positive and test negative hospitalized patients, respectively. While only 5·2% of patients were ICU admitted, case fatality rates outside ICU were 17·70% and 4·65% in test-positive and test-negative non-ICU admitted patients, correspondingly. The independent associates of death were age ≥ 70 years, testing positive with rRT-PCR test, having immunodeficiency disorders and ICU admission. Interpretation: Hospitalized COVID-19 patients with mild symptoms despite positive chest CT changes and major comorbidities were more probable to have negative rRT-PCR test result, hence lower case fatality rate and a more favorable outcome. Funding Statement: None. Declaration of Interests: The authors have nothing to disclose. Ethics Approval Statement: This study was approved by the Research Ethic Committee of Qazvin University of Medical Sciences (QUMS-EC).

Research paper thumbnail of Association between rRT-PCR test results upon admission and outcome in hospitalized chest CT-Positive COVID-19 patients; a provincial retrospective cohort with active follow-up

BackgroundThe Covid-19 pandemic imposed the most devastating challenge on healthcare systems worl... more BackgroundThe Covid-19 pandemic imposed the most devastating challenge on healthcare systems worldwide. Iran was among the first countries that had to confront serious shortages in RT-PCR testing for SARS-CoV-2 and ventilators availabilities throughout the COVID-19 outbreak. This study aimed to investigate the clinical course of hospitalized COVID-19 patients with different rRT-PCR test results during the first 3 weeks of the outbreak in Qazvin province, Iran.MethodsFor this retrospective cohort study, data of hospitalized patients primarily diagnosed as having COVID-19 in all 12 centers across the whole Qazvin province during Feb 20-Mar 11, 2020 was analyzed. A multivariate logistic regression model was applied to assess the independent associates of death among COVID-19 patients.Results998 patients (57% male, median age 54 years) with positive chest CT-scan changes were included in this study. Among them, 558 patients were examined with rRT-PCR test and 73·8% tested positive. Case...

Research paper thumbnail of Association between serum uric acid and proteinuria in patients with type 2 diabetes and stages 1 and 2 chronic kidney disease

Clinical Epidemiology and Global Health, 2019

Background:-Interaction between serum uric acid level and diabetic nephropathy is a matter of deb... more Background:-Interaction between serum uric acid level and diabetic nephropathy is a matter of debate. This study is designed to examine the association between serum uric acid (SUA) level and proteinuria in in type 2 diabetes patients with stages 1 and 2 chronic kidney disease (CKD). Material and methods:-For this cross-sectional study, type 2 diabetic patients aged ≥ 20 years were recruited from two clinics in Kermanshah city from February 2014 to February 2016. Demographic, anthropometric and metabolic data of participants were obtained. Male and female participants were analyzed separately by logistic regression. Results:-A total of 432 patients (63.7% women) with a mean ± standard deviation (SD) age of 54.68 ± 9.96 years were analyzed. Multivariate logistic regression model including age, diabetes duration, body mass index (BMI), estimated glomerular filtration rate (eGFR), fasting blood glucose (FBS), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and SUA showed that in male participants, SUA, FBS, DBP and eGFR significantly predicted proteinuria, while in female gender, SUA, HDL-C, DM duration and age were the independent correlates of proteinuria. Conclusions:-Serum uric acid significantly predicted proteinuria in both genders. Moreover, in women with type 2 diabetes and stages 1 and 2 CKD, while the association between eGFR and proteinuria was lost, serum uric acid level was independently correlated with the presence of proteinuria.

Research paper thumbnail of Association between sleep duration and nephropathy in patients with type II diabetes mellitus

International Journal of Diabetes in Developing Countries, 2018

Sleep disturbances have been shown to be associated with adverse health outcomes including diabet... more Sleep disturbances have been shown to be associated with adverse health outcomes including diabetes mellitus (DM), hypertension, and obesity. However, little is known about the relationship between sleep duration and diabetes complications. The present cross-sectional study aimed to examine the association between sleep duration and nephropathy in a population of type 2 DM patients. Diabetic patients aged ≥ 18 years who visited two outpatient clinics in Kermanshah from February 2014 to February 2015 entered the study. Demographic, anthropometric, and biochemical data, as well as information on sleep duration of participants within the past 4 weeks, were collected by an interviewer. Patients with estimated glomerular filtration rate (eGFR) ≤ 60 ml/24 h were excluded from the study. Proteinuria was defined as excretion of more than 150 mg protein in 24-h urine. Differences in urine protein and related variables were examined between four sleep duration groups (≤ 5, 6, 7, and ≥ 8 h). Linear and logistic regression analyses were employed to assess the association between sleep duration and diabetic nephropathy. Four hundred thirty-two patients (63.8% female) with a mean age of 54.68 ± 9.98 years were analyzed. There were statistically significant differences in age, body mass index, waist circumference, DM duration, HbA1C, total cholesterol, HDL cholesterol, triglyceride, uric acid, and urine protein between sleep duration groups. While adjusted linear regression showed no association between sleep duration and urine protein (p = 0.300), multivariable logistic regression revealed male gender, increased HbA1C, shorter sleep duration, increased DM duration, lower eGFR, higher DBP, decreased HDL-C, and higher uric acid levels to be statistically associated with proteinuria. Short sleep duration is adversely associated with proteinuria in type 2 DM patients with normal and near-normal kidney function.

Research paper thumbnail of Legacy of the Tehran Lipid and Glucose Study: Chronic Kidney Disease

International Journal of Endocrinology and Metabolism, 2018

Context: Chronic kidney disease (CKD), is correlated with a substantial upsurge in mortality and ... more Context: Chronic kidney disease (CKD), is correlated with a substantial upsurge in mortality and morbidity worldwide. In this review, we aimed to review the 20-year-findings on CKD of the Tehran lipid and glucose study (TLGS). Evidence Acquisition: We conducted a systematic review of all studies on CKD that had been performed in the context of TLGS. Results: Age adjusted prevalence of CKD, according to estimated glomerular filtration rate (eGFR) assessed with the two abbreviated equations of the modification of diet in renal disease (MDRD) and the CKD epidemiology collaboration (CKD-EPI) were 11.3% (95% confidence interval (CI): 10.7, 12.0) and 8.5% (95% CI: 7.9, 9.1), respectively. Using MDRD equation, over a mean follow up of 9.9 years, the incidence density rates of CKD were 285.3 person years in women and 132.6 per 10000 person-years in men. Studies on the TLGS population documented that abdominal adiposity defined as waist circumference (WC) categories (P for trend < 0.02) and waist gain in men (hazard ratio (HR) = 1.7, CI: 1.3, 2.2) significantly affected CKD development. Also, CKD had a significant effect on coronary heart disease (CHD) only in participants with low body mass index (HR = 2.06; CI: 1.28, 3.31 and HR = 2.56; CI: 1.04, 6.31 in men and women, respectively). Moreover, CKD was among the strongest independent predictors of stroke (HR = 2.01, CI: 1.22, 3.33). Also, compared to diabetic patients, an abnormal ECG was more prevalent in moderate CKD (P = 0.02). Conclusions: Increased waist circumference and waist gain (only in men) were associated with developing CKD in the TLGS population. CKD was an independent predictor of CHD (in lean individuals) and stroke.

Research paper thumbnail of Predictors of incident obesity phenotype in nonobese healthy adults

European Journal of Clinical Investigation, 2017

Background: Despite their different cardiovascular consequences, little is known about predictors... more Background: Despite their different cardiovascular consequences, little is known about predictors of metabolically healthy (MHO) and metabolically unhealthy (MUHO) obesity. This cohort study was designed to address this question in participants of the Tehran Lipid and Glucose Study. Materials and methods: Employing the Joint Interim Statement (JIS) metabolic syndrome criteria to define MHO/MUHO phenotypes, non-obese, otherwise healthy individuals, aged >20 years (n= 3489) were recruited and followed up for a median of 13.4 years. Results: At the follow up, MHO incidence rate in obese individuals was 36.6%. Comparing MHO vs. MUHO, female gender (odds ratio (OR)=3.28, 95% confidence interval (CI) 1.27, 8.46)), increased body mass index (BMI) (OR=1.32, 95% CI 1.12, 1.60) and elevated high This article is protected by copyright. All rights reserved. density lipoprotein-cholesterol (HDL-C) levels (OR=1.04, 95% CI 1.02, 1.07) were related to higher odds of incident MHO, while older age (OR=0.95, 95% CI 0.92, 0.98), increased waist circumference (WC) (OR=0.86, 95% CI 0.81, 0.91), higher WC gain (OR=0.91, 95% CI 0.87, 0.95) and increased diastolic blood pressure (DBP) (OR=0.94, 95% CI 0.91, 0.98) prevented progression toward MHO. Conclusions: While baseline BMI and WC were detrimental for developing MHO vs. MUHO, gender was the strongest predictor of incident obesity phenotype in healthy non-obese individuals.

Research paper thumbnail of The relation between changes in thyroid function and anthropometric indices during long-term follow-up of euthyroid subjects: the Tehran Thyroid Study (TTS)

European Journal of Endocrinology, 2016

ObjectiveUncertainties exist regarding the causal relationship between thyroid function tests (TF... more ObjectiveUncertainties exist regarding the causal relationship between thyroid function tests (TFT) within the euthyroid range and anthropometric measures. This longitudinal cohort is aimed to examine the relationship between the two conditions.Subjects and methodsEuthyroid participants of Tehran Thyroid Study (TTS) attending phase I (1999–2001) were included in this study and were followed up to phase IV (2008–2011). TSH and free T4(fT4) levels as well as weight (Wt), waist circumference (WC), hip circumference (HC) and waist-to-hip ratio (WHR) were measured at both phases.Results971 women and 784 men were included in the analysis. During 9.7years of follow-up, increases in TSH levels, Wt and WHR as well as a decrease in fT4level were observed. Multivariable regression analysis showed a significant relationship between TSH changes and alterations in WC in women (β=0.69,P=0.021) and men (β=0.61,P=0.038). Moreover, a significant negative association of ΔfT4with changes in weight was ...

Research paper thumbnail of Instability of different adolescent metabolic syndrome definitions tracked into early adulthood metabolic syndrome: Tehran Lipid and Glucose Study (TLGS)

Pediatric Diabetes, 2016

There are substantial controversies about the clinical utility of adolescent metabolic syndrome (... more There are substantial controversies about the clinical utility of adolescent metabolic syndrome (MetS). The current study examined the stability of adolescent MetS by assessing the agreement and discriminative abilities of four different definitions of adolescent MetS and the adult MetS definition during a 10.4-yr follow up. For this study, 1424 adolescents (55.2% female), who participated in the framework of the Tehran Lipid and Glucose Study were included. Kappa was calculated for agreement between adolescent MetS definitions [Cook, de Ferranti, pediatric National Cholesterol Education Program (NCEP) and pediatric International Diabetes Federation (IDF)] and the adulthood MetS definition defined by the joint interim statement (JIS) criteria. MetS persistence, instability, and incidence were assessed, and for each of the four adolescent definitions, sensitivity, specificity, and area under receiver operating curve (AUC) for the counting of categorical adulthood MetS components was evaluated. The agreement between the four adolescent MetS definitions and JIS was poor (κ = 0.094-0.255). All definitions showed low sensitivity and high specificity, except for de Ferranti&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s, which contrary to other definitions, had higher sensitivity and lower specificity. All four adolescent definitions revealed generally low AUCs (0.601-0.647). Compared with the pubertal group (11-14 yr), the predictive power was slightly higher in the late-pubertal group (15-18 yr). Cook&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s and de Ferranti&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s definitions showed fairly better predictive powers (0.647 and 0.644, respectively). Across all definitions, instability ranged between 5.4 and 19.6%. The adolescent definitions show considerable amount of instability defined as poor agreement and low discriminative abilities tracked into early adulthood.

Research paper thumbnail of Capacity Development in Health Research System

Research paper thumbnail of Research Utilization

Research paper thumbnail of Preliminary report on the effects of melodic intonation therapy in the rehabilitation of Persian aphasic patients

Research paper thumbnail of Decomposition of socioeconomic inequality in COVID‐19 mortality in Iran: A retrospective cohort study

Health & Social Care in The Community, Nov 5, 2021

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Research paper thumbnail of Predictors of incident obesity phenotype in nonobese healthy adults

European Journal of Clinical Investigation, Apr 5, 2017

Background: Despite their different cardiovascular consequences, little is known about predictors... more Background: Despite their different cardiovascular consequences, little is known about predictors of metabolically healthy (MHO) and metabolically unhealthy (MUHO) obesity. This cohort study was designed to address this question in participants of the Tehran Lipid and Glucose Study. Materials and methods: Employing the Joint Interim Statement (JIS) metabolic syndrome criteria to define MHO/MUHO phenotypes, non-obese, otherwise healthy individuals, aged >20 years (n= 3489) were recruited and followed up for a median of 13.4 years. Results: At the follow up, MHO incidence rate in obese individuals was 36.6%. Comparing MHO vs. MUHO, female gender (odds ratio (OR)=3.28, 95% confidence interval (CI) 1.27, 8.46)), increased body mass index (BMI) (OR=1.32, 95% CI 1.12, 1.60) and elevated high This article is protected by copyright. All rights reserved. density lipoprotein-cholesterol (HDL-C) levels (OR=1.04, 95% CI 1.02, 1.07) were related to higher odds of incident MHO, while older age (OR=0.95, 95% CI 0.92, 0.98), increased waist circumference (WC) (OR=0.86, 95% CI 0.81, 0.91), higher WC gain (OR=0.91, 95% CI 0.87, 0.95) and increased diastolic blood pressure (DBP) (OR=0.94, 95% CI 0.91, 0.98) prevented progression toward MHO. Conclusions: While baseline BMI and WC were detrimental for developing MHO vs. MUHO, gender was the strongest predictor of incident obesity phenotype in healthy non-obese individuals.

Research paper thumbnail of A Bibliometric Study of Scientific Literature on Obesity Research in Web of Science Database (2008-2020): Evidence from the MENA Region

Iranian journal of public health, May 22, 2023

Background: Obesity has increasingly become a health threat in the Middle East and North Africa (... more Background: Obesity has increasingly become a health threat in the Middle East and North Africa (MENA) countries. This study aimed to investigate the scientific publications on obesity in the MENA countries during 2008-2020. Methods: A longitudinal analysis of 13 years (2008-2020) of bibliographic data from obesity-related articles was performed. Web of Science core collection (WoS) was searched for bibliographic data. The bibliometric indicators including overall productivity and collaboration along with the prevalence of obesity and socioeconomic status were used to assess and compare the context of obesity research efforts in the MENA region. Results: The overall obesity-related articles of the MENA countries cumulated to 23680 publications. The MENA region accounted for a 6.5% global publication share in obesity research. Turkey contributed the highest rate of total publications (n=6162) followed by Iran (n=5302) and Israel (n=2847). Iran and Turkey had the lowest rates of international collaborations. The overall obesity research was not significantly associated with socio-demographic index (SDI) measure (r=-0.26, P=0.27). No significant association was found between Gross National Income (GNI) per capita and the overall production of obesity research (r=0.41, P=0.08). Additionally, obesity research was not significantly associated with the prevalence of obesity in the countries (r=0.24, P=0.30). Conclusion: This study observed an increased share of scientific productivity in the field of obesity from the MENA countries. Neither SDI, GNI per capita, nor obesity prevalence was not significantly associated with the overall productivity of the region.

Research paper thumbnail of Association between sleep duration and nephropathy in patients with type II diabetes mellitus

International Journal of Diabetes in Developing Countries, Jan 23, 2018

Sleep disturbances have been shown to be associated with adverse health outcomes including diabet... more Sleep disturbances have been shown to be associated with adverse health outcomes including diabetes mellitus (DM), hypertension, and obesity. However, little is known about the relationship between sleep duration and diabetes complications. The present cross-sectional study aimed to examine the association between sleep duration and nephropathy in a population of type 2 DM patients. Diabetic patients aged ≥ 18 years who visited two outpatient clinics in Kermanshah from February 2014 to February 2015 entered the study. Demographic, anthropometric, and biochemical data, as well as information on sleep duration of participants within the past 4 weeks, were collected by an interviewer. Patients with estimated glomerular filtration rate (eGFR) ≤ 60 ml/24 h were excluded from the study. Proteinuria was defined as excretion of more than 150 mg protein in 24-h urine. Differences in urine protein and related variables were examined between four sleep duration groups (≤ 5, 6, 7, and ≥ 8 h). Linear and logistic regression analyses were employed to assess the association between sleep duration and diabetic nephropathy. Four hundred thirty-two patients (63.8% female) with a mean age of 54.68 ± 9.98 years were analyzed. There were statistically significant differences in age, body mass index, waist circumference, DM duration, HbA1C, total cholesterol, HDL cholesterol, triglyceride, uric acid, and urine protein between sleep duration groups. While adjusted linear regression showed no association between sleep duration and urine protein (p = 0.300), multivariable logistic regression revealed male gender, increased HbA1C, shorter sleep duration, increased DM duration, lower eGFR, higher DBP, decreased HDL-C, and higher uric acid levels to be statistically associated with proteinuria. Short sleep duration is adversely associated with proteinuria in type 2 DM patients with normal and near-normal kidney function.

Research paper thumbnail of Instability of different adolescent metabolic syndrome definitions tracked into early adulthood metabolic syndrome: Tehran Lipid and Glucose Study (TLGS)

Pediatric Diabetes, Jan 30, 2016

There are substantial controversies about the clinical utility of adolescent metabolic syndrome (... more There are substantial controversies about the clinical utility of adolescent metabolic syndrome (MetS). The current study examined the stability of adolescent MetS by assessing the agreement and discriminative abilities of four different definitions of adolescent MetS and the adult MetS definition during a 10.4-yr follow up. For this study, 1424 adolescents (55.2% female), who participated in the framework of the Tehran Lipid and Glucose Study were included. Kappa was calculated for agreement between adolescent MetS definitions [Cook, de Ferranti, pediatric National Cholesterol Education Program (NCEP) and pediatric International Diabetes Federation (IDF)] and the adulthood MetS definition defined by the joint interim statement (JIS) criteria. MetS persistence, instability, and incidence were assessed, and for each of the four adolescent definitions, sensitivity, specificity, and area under receiver operating curve (AUC) for the counting of categorical adulthood MetS components was evaluated. The agreement between the four adolescent MetS definitions and JIS was poor (κ = 0.094-0.255). All definitions showed low sensitivity and high specificity, except for de Ferranti&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s, which contrary to other definitions, had higher sensitivity and lower specificity. All four adolescent definitions revealed generally low AUCs (0.601-0.647). Compared with the pubertal group (11-14 yr), the predictive power was slightly higher in the late-pubertal group (15-18 yr). Cook&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s and de Ferranti&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s definitions showed fairly better predictive powers (0.647 and 0.644, respectively). Across all definitions, instability ranged between 5.4 and 19.6%. The adolescent definitions show considerable amount of instability defined as poor agreement and low discriminative abilities tracked into early adulthood.

Research paper thumbnail of The Association Between Subclinical Hypothyroidism and Metabolic Syndrome as Defined by the ATP III Criteria

Metabolic Syndrome and Related Disorders, Apr 1, 2016

The association between subclinical hypothyroidism (SCH) and metabolic syndrome (MetS) is a matte... more The association between subclinical hypothyroidism (SCH) and metabolic syndrome (MetS) is a matter of debate. In this study, we aimed to examine the risk of MetS in SCH through a systematic review and meta-analysis. A systematic search of published literature up to September 2015 was conducted. General population studies were included if they had considered SCH as the independent variable. After data extraction, a meta-analysis was run to assess the odds ratio (OR) of MetS and its components between subclinical hypothyroid and euthyroid groups. Only studies employing Adult Treatment Panel III (ATP III) criteria for MetS were included in the meta-analysis. In the SCH group, female gender was more prevalent [OR = 1.65, 95% confidence interval (95% CI) 1.29-2.13]. Meta-analysis showed no significant difference in MetS prevalence between SCH and euthyroid individuals (OR = 1.13, 95% CI 0.95-1.34). However, the prevalence of central obesity (OR = 1.43, 95% CI 1.04-1.96) was significantly higher in the SCH group. On the other hand, hypertriglyceridemia was more prevalent in the female-only SCH subgroup. In conclusion, although we found some MetS components to be more prevalent in SCH, the prevalence of MetS as defined by ATP III criteria was not increased in SCH. Considerable heterogeneity observed may have influenced the results on MetS components.

Research paper thumbnail of Association between serum uric acid and proteinuria in patients with type 2 diabetes and stages 1 and 2 chronic kidney disease

Clinical Epidemiology and Global Health, Mar 1, 2020

Background:-Interaction between serum uric acid level and diabetic nephropathy is a matter of deb... more Background:-Interaction between serum uric acid level and diabetic nephropathy is a matter of debate. This study is designed to examine the association between serum uric acid (SUA) level and proteinuria in in type 2 diabetes patients with stages 1 and 2 chronic kidney disease (CKD). Material and methods:-For this cross-sectional study, type 2 diabetic patients aged ≥ 20 years were recruited from two clinics in Kermanshah city from February 2014 to February 2016. Demographic, anthropometric and metabolic data of participants were obtained. Male and female participants were analyzed separately by logistic regression. Results:-A total of 432 patients (63.7% women) with a mean ± standard deviation (SD) age of 54.68 ± 9.96 years were analyzed. Multivariate logistic regression model including age, diabetes duration, body mass index (BMI), estimated glomerular filtration rate (eGFR), fasting blood glucose (FBS), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and SUA showed that in male participants, SUA, FBS, DBP and eGFR significantly predicted proteinuria, while in female gender, SUA, HDL-C, DM duration and age were the independent correlates of proteinuria. Conclusions:-Serum uric acid significantly predicted proteinuria in both genders. Moreover, in women with type 2 diabetes and stages 1 and 2 CKD, while the association between eGFR and proteinuria was lost, serum uric acid level was independently correlated with the presence of proteinuria.

Research paper thumbnail of National and Regional Fraction of Cancer Incidence and Death Attributable to Current Tobacco and Water-Pipe Smoking in the Eastern Mediterranean Countries in 2020

Nicotine & Tobacco Research

Introduction We aimed to calculate the Population Attributable Fraction (PAF) of cancers due to t... more Introduction We aimed to calculate the Population Attributable Fraction (PAF) of cancers due to tobacco use in the Eastern Mediterranean Region (EMRO), where water-pipe smoking is prevalent but its effect was not considered in previous studies. Aims and Methods We applied Levin’s formula to estimate PAFs of cancers due to tobacco use (defined as all type tobacco including both cigarette and water-pipe). We also calculated PAF of water-pipe smoking separately. Exposure prevalence data were retrieved from representative national and subnational surveys. Data on cancer incidence and death were also and cancer cases were obtained GLOBOCAN 2020. We also obtained associated relative risks from published meta-analyses. Results Of the total 715 658 incident adult cancer cases that were reported in 2020 in EMRO, 14.6% (n = 104 800) was attributable to tobacco smoking (26.9% [n = 92 753]) in men versus 3.3% (n = 12 048) in women. Further, 1.0% of incident adult cancers were attributable to cu...

Research paper thumbnail of Preliminary report on the efficacy of Melodic Intonation Therapy in Persian aphasic patients

Iranian Journal of Medical Sciences, 2000

Research paper thumbnail of rRT-PCR Test Results Upon Admission Might Be Associated with Outcome in Hospitalized Chest CT-Positive COVID-19 Patients: A Provincial Retrospective Cohort with Active Follow-Up

SSRN Electronic Journal, 2020

Background: The Covid-19 pandemic imposed the most devastating challenge on healthcare systems wo... more Background: The Covid-19 pandemic imposed the most devastating challenge on healthcare systems worldwide. Iran was among the first countries that had to confront serious shortages in RT-PCR testing for SARS-CoV-2 and ventilators availabilities amid the COVID-19 outbreak. This study aimed to investigate the clinical course of hospitalized COVID-19 patients with different rRT-PCR test results during the first 3 weeks of the outbreak in Qazvin province, Iran. Methods: Data of hospitalized patients primarily diagnosed as having COVID-19 in all 12 centers across the whole Qazvin province during Feb 20-Mar 11, 2020 was analyzed for this retrospective cohort study. A multivariate logistic regression model was applied to assess the independent associates of death among COVID-19 patients. Findings: 998 patients (57% male, median age 54 years) with positive chest CT-scan changes were included in this study. Among them, 558 patients were examined with rRT-PCR test and 73·8% tested positive. Case fatality rate was 20·68% and 7·53% among test-positive and test negative hospitalized patients, respectively. While only 5·2% of patients were ICU admitted, case fatality rates outside ICU were 17·70% and 4·65% in test-positive and test-negative non-ICU admitted patients, correspondingly. The independent associates of death were age ≥ 70 years, testing positive with rRT-PCR test, having immunodeficiency disorders and ICU admission. Interpretation: Hospitalized COVID-19 patients with mild symptoms despite positive chest CT changes and major comorbidities were more probable to have negative rRT-PCR test result, hence lower case fatality rate and a more favorable outcome. Funding Statement: None. Declaration of Interests: The authors have nothing to disclose. Ethics Approval Statement: This study was approved by the Research Ethic Committee of Qazvin University of Medical Sciences (QUMS-EC).

Research paper thumbnail of Association between rRT-PCR test results upon admission and outcome in hospitalized chest CT-Positive COVID-19 patients; a provincial retrospective cohort with active follow-up

BackgroundThe Covid-19 pandemic imposed the most devastating challenge on healthcare systems worl... more BackgroundThe Covid-19 pandemic imposed the most devastating challenge on healthcare systems worldwide. Iran was among the first countries that had to confront serious shortages in RT-PCR testing for SARS-CoV-2 and ventilators availabilities throughout the COVID-19 outbreak. This study aimed to investigate the clinical course of hospitalized COVID-19 patients with different rRT-PCR test results during the first 3 weeks of the outbreak in Qazvin province, Iran.MethodsFor this retrospective cohort study, data of hospitalized patients primarily diagnosed as having COVID-19 in all 12 centers across the whole Qazvin province during Feb 20-Mar 11, 2020 was analyzed. A multivariate logistic regression model was applied to assess the independent associates of death among COVID-19 patients.Results998 patients (57% male, median age 54 years) with positive chest CT-scan changes were included in this study. Among them, 558 patients were examined with rRT-PCR test and 73·8% tested positive. Case...

Research paper thumbnail of Association between serum uric acid and proteinuria in patients with type 2 diabetes and stages 1 and 2 chronic kidney disease

Clinical Epidemiology and Global Health, 2019

Background:-Interaction between serum uric acid level and diabetic nephropathy is a matter of deb... more Background:-Interaction between serum uric acid level and diabetic nephropathy is a matter of debate. This study is designed to examine the association between serum uric acid (SUA) level and proteinuria in in type 2 diabetes patients with stages 1 and 2 chronic kidney disease (CKD). Material and methods:-For this cross-sectional study, type 2 diabetic patients aged ≥ 20 years were recruited from two clinics in Kermanshah city from February 2014 to February 2016. Demographic, anthropometric and metabolic data of participants were obtained. Male and female participants were analyzed separately by logistic regression. Results:-A total of 432 patients (63.7% women) with a mean ± standard deviation (SD) age of 54.68 ± 9.96 years were analyzed. Multivariate logistic regression model including age, diabetes duration, body mass index (BMI), estimated glomerular filtration rate (eGFR), fasting blood glucose (FBS), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and SUA showed that in male participants, SUA, FBS, DBP and eGFR significantly predicted proteinuria, while in female gender, SUA, HDL-C, DM duration and age were the independent correlates of proteinuria. Conclusions:-Serum uric acid significantly predicted proteinuria in both genders. Moreover, in women with type 2 diabetes and stages 1 and 2 CKD, while the association between eGFR and proteinuria was lost, serum uric acid level was independently correlated with the presence of proteinuria.

Research paper thumbnail of Association between sleep duration and nephropathy in patients with type II diabetes mellitus

International Journal of Diabetes in Developing Countries, 2018

Sleep disturbances have been shown to be associated with adverse health outcomes including diabet... more Sleep disturbances have been shown to be associated with adverse health outcomes including diabetes mellitus (DM), hypertension, and obesity. However, little is known about the relationship between sleep duration and diabetes complications. The present cross-sectional study aimed to examine the association between sleep duration and nephropathy in a population of type 2 DM patients. Diabetic patients aged ≥ 18 years who visited two outpatient clinics in Kermanshah from February 2014 to February 2015 entered the study. Demographic, anthropometric, and biochemical data, as well as information on sleep duration of participants within the past 4 weeks, were collected by an interviewer. Patients with estimated glomerular filtration rate (eGFR) ≤ 60 ml/24 h were excluded from the study. Proteinuria was defined as excretion of more than 150 mg protein in 24-h urine. Differences in urine protein and related variables were examined between four sleep duration groups (≤ 5, 6, 7, and ≥ 8 h). Linear and logistic regression analyses were employed to assess the association between sleep duration and diabetic nephropathy. Four hundred thirty-two patients (63.8% female) with a mean age of 54.68 ± 9.98 years were analyzed. There were statistically significant differences in age, body mass index, waist circumference, DM duration, HbA1C, total cholesterol, HDL cholesterol, triglyceride, uric acid, and urine protein between sleep duration groups. While adjusted linear regression showed no association between sleep duration and urine protein (p = 0.300), multivariable logistic regression revealed male gender, increased HbA1C, shorter sleep duration, increased DM duration, lower eGFR, higher DBP, decreased HDL-C, and higher uric acid levels to be statistically associated with proteinuria. Short sleep duration is adversely associated with proteinuria in type 2 DM patients with normal and near-normal kidney function.

Research paper thumbnail of Legacy of the Tehran Lipid and Glucose Study: Chronic Kidney Disease

International Journal of Endocrinology and Metabolism, 2018

Context: Chronic kidney disease (CKD), is correlated with a substantial upsurge in mortality and ... more Context: Chronic kidney disease (CKD), is correlated with a substantial upsurge in mortality and morbidity worldwide. In this review, we aimed to review the 20-year-findings on CKD of the Tehran lipid and glucose study (TLGS). Evidence Acquisition: We conducted a systematic review of all studies on CKD that had been performed in the context of TLGS. Results: Age adjusted prevalence of CKD, according to estimated glomerular filtration rate (eGFR) assessed with the two abbreviated equations of the modification of diet in renal disease (MDRD) and the CKD epidemiology collaboration (CKD-EPI) were 11.3% (95% confidence interval (CI): 10.7, 12.0) and 8.5% (95% CI: 7.9, 9.1), respectively. Using MDRD equation, over a mean follow up of 9.9 years, the incidence density rates of CKD were 285.3 person years in women and 132.6 per 10000 person-years in men. Studies on the TLGS population documented that abdominal adiposity defined as waist circumference (WC) categories (P for trend < 0.02) and waist gain in men (hazard ratio (HR) = 1.7, CI: 1.3, 2.2) significantly affected CKD development. Also, CKD had a significant effect on coronary heart disease (CHD) only in participants with low body mass index (HR = 2.06; CI: 1.28, 3.31 and HR = 2.56; CI: 1.04, 6.31 in men and women, respectively). Moreover, CKD was among the strongest independent predictors of stroke (HR = 2.01, CI: 1.22, 3.33). Also, compared to diabetic patients, an abnormal ECG was more prevalent in moderate CKD (P = 0.02). Conclusions: Increased waist circumference and waist gain (only in men) were associated with developing CKD in the TLGS population. CKD was an independent predictor of CHD (in lean individuals) and stroke.

Research paper thumbnail of Predictors of incident obesity phenotype in nonobese healthy adults

European Journal of Clinical Investigation, 2017

Background: Despite their different cardiovascular consequences, little is known about predictors... more Background: Despite their different cardiovascular consequences, little is known about predictors of metabolically healthy (MHO) and metabolically unhealthy (MUHO) obesity. This cohort study was designed to address this question in participants of the Tehran Lipid and Glucose Study. Materials and methods: Employing the Joint Interim Statement (JIS) metabolic syndrome criteria to define MHO/MUHO phenotypes, non-obese, otherwise healthy individuals, aged >20 years (n= 3489) were recruited and followed up for a median of 13.4 years. Results: At the follow up, MHO incidence rate in obese individuals was 36.6%. Comparing MHO vs. MUHO, female gender (odds ratio (OR)=3.28, 95% confidence interval (CI) 1.27, 8.46)), increased body mass index (BMI) (OR=1.32, 95% CI 1.12, 1.60) and elevated high This article is protected by copyright. All rights reserved. density lipoprotein-cholesterol (HDL-C) levels (OR=1.04, 95% CI 1.02, 1.07) were related to higher odds of incident MHO, while older age (OR=0.95, 95% CI 0.92, 0.98), increased waist circumference (WC) (OR=0.86, 95% CI 0.81, 0.91), higher WC gain (OR=0.91, 95% CI 0.87, 0.95) and increased diastolic blood pressure (DBP) (OR=0.94, 95% CI 0.91, 0.98) prevented progression toward MHO. Conclusions: While baseline BMI and WC were detrimental for developing MHO vs. MUHO, gender was the strongest predictor of incident obesity phenotype in healthy non-obese individuals.

Research paper thumbnail of The relation between changes in thyroid function and anthropometric indices during long-term follow-up of euthyroid subjects: the Tehran Thyroid Study (TTS)

European Journal of Endocrinology, 2016

ObjectiveUncertainties exist regarding the causal relationship between thyroid function tests (TF... more ObjectiveUncertainties exist regarding the causal relationship between thyroid function tests (TFT) within the euthyroid range and anthropometric measures. This longitudinal cohort is aimed to examine the relationship between the two conditions.Subjects and methodsEuthyroid participants of Tehran Thyroid Study (TTS) attending phase I (1999–2001) were included in this study and were followed up to phase IV (2008–2011). TSH and free T4(fT4) levels as well as weight (Wt), waist circumference (WC), hip circumference (HC) and waist-to-hip ratio (WHR) were measured at both phases.Results971 women and 784 men were included in the analysis. During 9.7years of follow-up, increases in TSH levels, Wt and WHR as well as a decrease in fT4level were observed. Multivariable regression analysis showed a significant relationship between TSH changes and alterations in WC in women (β=0.69,P=0.021) and men (β=0.61,P=0.038). Moreover, a significant negative association of ΔfT4with changes in weight was ...

Research paper thumbnail of Instability of different adolescent metabolic syndrome definitions tracked into early adulthood metabolic syndrome: Tehran Lipid and Glucose Study (TLGS)

Pediatric Diabetes, 2016

There are substantial controversies about the clinical utility of adolescent metabolic syndrome (... more There are substantial controversies about the clinical utility of adolescent metabolic syndrome (MetS). The current study examined the stability of adolescent MetS by assessing the agreement and discriminative abilities of four different definitions of adolescent MetS and the adult MetS definition during a 10.4-yr follow up. For this study, 1424 adolescents (55.2% female), who participated in the framework of the Tehran Lipid and Glucose Study were included. Kappa was calculated for agreement between adolescent MetS definitions [Cook, de Ferranti, pediatric National Cholesterol Education Program (NCEP) and pediatric International Diabetes Federation (IDF)] and the adulthood MetS definition defined by the joint interim statement (JIS) criteria. MetS persistence, instability, and incidence were assessed, and for each of the four adolescent definitions, sensitivity, specificity, and area under receiver operating curve (AUC) for the counting of categorical adulthood MetS components was evaluated. The agreement between the four adolescent MetS definitions and JIS was poor (κ = 0.094-0.255). All definitions showed low sensitivity and high specificity, except for de Ferranti&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s, which contrary to other definitions, had higher sensitivity and lower specificity. All four adolescent definitions revealed generally low AUCs (0.601-0.647). Compared with the pubertal group (11-14 yr), the predictive power was slightly higher in the late-pubertal group (15-18 yr). Cook&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s and de Ferranti&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s definitions showed fairly better predictive powers (0.647 and 0.644, respectively). Across all definitions, instability ranged between 5.4 and 19.6%. The adolescent definitions show considerable amount of instability defined as poor agreement and low discriminative abilities tracked into early adulthood.

Research paper thumbnail of Capacity Development in Health Research System

Research paper thumbnail of Research Utilization

Research paper thumbnail of Preliminary report on the effects of melodic intonation therapy in the rehabilitation of Persian aphasic patients