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Objective: Long-distance professional drivers, as an occupational group, are hypothesized to have a higher risk of overweight and obesity. The aim of this study was to estimate the prevalence and risk factors of overweight, underweight, and obesity in long-distance professional drivers., Methods: A cross-sectional study was conducted on 36 625 male long-distance professional drivers age ≥20 years, from April 2013 to Sept. 2016. Drivers were interviewed and underwent clinical and laboratory examinations including measures of blood pressure (BP), blood tests, anthropometric data, and visual and hearing acuity. The mean (standard deviation [SD]) age of participants was 41.9 (10.2) years with a mean (SD) duration of a professional driving of 15.3 (9.6) years and mean (SD) body mass index (BMI) was 25.7 (4.0) kg/m 2 ., Results: The prevalence of overweight and obesity was 39.1% (95% confidence interval (CI) 38.6, 39.6) and 10.8% (95% CI 10.5, 11.1), respectively. A total percentage of 2.7 (95% CI 2.5, 2.9) were underweight. A total percentage of 10.6 had BMI 30-40 kg/m 2 and 0.2% had BMI ≥40 kg/m 2 . Using a stepwise binary logistic regression model for overweight, underweight, and obesity, age had a significant independent relationship with underweight, overweight, and obesity. Duration of work, BP, fasting plasma glucose, triglyceride, and cholesterol had significant independent positive association and smoking had a negative association with overweight/obesity when other covariates were considered., Conclusions: These findings indicate that overweight and obesity are prevalent among long-distance professional drivers in Iran and appears to be similar to the general population., (© 2020 The Authors. Journal of Occupational Health published by John Wiley & Sons Australia, Ltd on behalf of The Japan Society for Occupational Health.)

Introduction: Obesity is well recognized to be an important risk factor for hypertension (HTN), but it is not clear which obesity indices have stronger association with HTN., Aim: To evaluate the ability of different obesity indices, including visceral adiposity index (VAI), hypertriglyceridemic-waist (HTGW) phenotype, a body shape index (ABSI), body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR) as possible hypertension (HTN) predictor in a high-risk population., Methods: Seven years follow-up data in first-degree relatives of consecutive patients with type 2 diabetes aged 30-70 years without diabetes and HTN with at least one follow-up examination (n = 1417) were analysed. Discriminatory capabilities were examined using the receiver operating characteristic (ROC) curve. Logistic regression analysis was performed to determine the strength of association between obesity indices and HTN., Results: Among the indices, the highest quintile compared with the lowest quintile of WHtR and WC was more strongly associated with HTN in age and sex adjusted models [odds ratio (95% CI); WHtR: 4.02 (2.36, 6.85) and WC: 3.26 (2.05, 5.20)]. Those with HTGW phenotype was 2.3 (1.54, 3.35) times more likely to develop HTN than those with normal WC normal triglyceride. On ROC curve analysis, WHtR (63.1%; 59.6, 66.7) and WC (61.7%, 58.0, 65.4) had the higher area under the ROC., Conclusions: Although higher values of VAI, BMI, WHR and HTGW were associated with the risk of HTN, WHtR and WC was more strongly associated with the development of HTN, while the ABSI showed weaker association.

Aims: The aim of this study was to compare the utility of glycated hemoglobin (GHb) versus the fasting plasma glucose (FPG) in definition of glycemic component of the metabolic syndrome (MetS) in a non-diabetic Iranian population., Methods: A cross-sectional study of first-degree relatives (FDRs) of patients with type 2 diabetes was conducted from 2003 to 2005. A total of 2410 non-diabetic FDRs of consecutive patients with type 2 diabetes 30-60 years old were examined. All subjects underwent a standard 75 g 2-h oral glucose tolerance test and GHb measurement. Consensus criteria in 2009 were used to identify MetS. Glycemic component of MetS was defined as either FPG≥100 mg/dl or GHb≥5.7%. The mean (SD) age of participants was 43.6 (6.5) years., Results: The prevalence of MetS was 33.5% (95% confidence interval (CI): 31.6, 35.4) based on FPG criterion alone and 28.6% (95% CI: 26.8, 30.4) based on GHb criterion alone. Use of combination of both criteria increased the prevalence of MetS (36.7%; 95% CI: 34.8, 38.6). There was 88.7% (95% CI: 87.5, 90.0) agreement between the GHb and FPG when either was used to define MetS (κ coefficient=0.737)., Conclusions: These data indicate that using GHb may be an acceptable surrogate of FPG to define glycemic component of MetS., (Copyright © 2012 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

This study describes patterns of long-term weight changes among patients with type 2 diabetes mellitus (DM) and identifies factors associated with weight changes. During the mean follow-up period of 9.1 (SD 3.6; range 1-15) years, 7,820 patients with type 2 DM have been examined to determine weight changes. Their weight at the last clinic visit was compared with that at the initial visit. The mean age of the participants was 51.3 (SD 10.5) years, with a mean DM duration of 6.1 (SD 5.6) years at initial registration. Mean weight change was -1.9% (95% confidence interval, CI -2.1 to -1.7) and varied according to the severity of baseline obesity (-4.1%; 95% CI -4.6 to -3.6) for normal weight, -8.9% (95% CI -13.0 to -4.8) for underweight, -1.7% (95% CI -2.1 to -1.3) for overweight and -0.3% (95% CI -0.03 to +0.73) for obese, and +0.2% (95% CI -1.8 to +2.1) for morbidly obese patients. Using a stepwise multiple regression model, higher body mass index, follow-up, fasting plasma glucose, systolic blood pressure, triglyceride level and treatment with insulin increased the percent weight change, and higher number of follow-up, cholesterol and smoking significantly decreased it. Although this Iranian patients with type 2 DM had negligible weight change over 9.1 years on average, several clinical and lifestyle characteristics were associated with weight change., (2009 S. Karger AG, Basel.)

Background: Obesity continues to be an important public health problem worldwide. The objective of this study was to determine the association of body mass index and abdominal obesity with current marital status among the adult population of Iran., Methods: A nation-wide cross-sectional survey was conducted from December 2004 through February 2005.The subjects were selected by stratified probability cluster sampling through household family members in Iran. Weight, height, waist circumference, and marital status of 89,404 men and women aged 15 - 65 (mean: 39.2) years were recorded. Four classes of body mass index, i.e., <18.5, 18.5 - 24.9, 25 - 29.9, and > or =30 kg/cm2, and three marital status, i.e., currently-, formerly-, and never-married were used. Abdominal obesity was defined as waist circumference > or =102 cm in men and > or =88 cm in women., Results: The prevalence of overweight was twofold higher in married men (OR: 2.24; 95% CI: 2.08 - 2.41) and women (OR: 2.36; 95% CI: 2.20 - 2.53) than never-married men and women, even when age, educational level, leisure time physical activity, smoking habits, and place of residence were controlled. The multivariate OR of obesity was increased about threefold in married men (2.82; 95% CI: 2.51 - 3.18) and women (3.64; 95% CI: 3.31 - 3.99). The prevalence of abdominal obesity was twofold higher among married men (2.02; 95% CI: 1.79 - 2.29) and about threefold higher among married women (2.87; 95% CI: 2.69 - 3.06)., Conclusion: The marital status appears to influence the likelihood of developing overweight, obesity, and abdominal obesity in both men and women in Iran.

Objective: The aim of this study was to estimate the prevalence and risk factors of prehypertension (Pre-HTN) and hypertension (HTN) among the adult population of Iran., Methods: A nationwide cross-sectional survey was conducted from December 2004 to February 2005. The selection was conducted by stratified probability cluster sampling through household family members in Iran. Blood pressure (BP) and associated risk factors of 35 048 men and 34 674 women aged 25-65 years (mean 44.1 years) were measured., Results: The prevalence of Pre-HTN was 59.6% in men and 44.5% in women; and 19.8% of men and 26.9% of women were hypertensive, according to Joint National Committee 7 criteria. Pre-HTN was more common among men whereas HTN was more common among women. Multivariate analysis revealed that age, overweight, obesity, abdominal obesity and high cholesterol were strongly associated with Pre-HTN in both genders. In women, low educational attainment, residence in an urban area and high blood glucose were also associated with Pre-HTN. Age, low educational attainment, overweight, obesity, abdominal obesity and high cholesterol and blood glucose were strongly associated with HTN in both genders., Conclusion: Pre-HTN and HTN appear to be quiet common in Iran and were associated with obesity. More men than women present with Pre-HTN, whereas more women than men present with HTN. Prevention and treatment strategies are urgently needed to address the health burden of Pre-HTN and HTN and to prevent prehypertensive people from developing HTN and cardiovascular disease.

Objective: The goal was to estimate the prevalence of overweight, obesity, underweight, and abdominal obesity among the adult population of Iran., Research Methods and Procedures: A nationwide cross-sectional survey was conducted from December 2004 to February 2005. The selection was conducted by stratified probability cluster sampling through household family members in Iran. Weight, height, and waist circumference (WC) of 89,404 men and women 15 to 65 years of age (mean, 39.2 years) were measured. The criteria for underweight, normal-weight, overweight, and Class I, II, and III obesity were BMI <18.5, 18.5 to 24.9, 25 to 29.9, 30 to 34.9, 35 to 39.9, and >or=40 (kg/m(2)), respectively. Abdominal obesity was defined as WC >or=102 cm in men and >or=88 cm in women., Results: The age-adjusted means for BMI and WC were 24.6 kg/m(2) in men and 26.5 kg/m(2) in women and 86.6 cm in men and 89.6 cm in women, respectively. The age-adjusted prevalence of overweight or obesity (BMI >or=25) was 42.8% in men and 57.0% in women; 11.1% of men and 25.2% of women were obese (BMI >or=30), while 6.3% of men and 5.2% of women were underweight. Age, low physical activity, low educational attainment, marriage, and residence in urban areas were strongly associated with obesity. Abdominal obesity was more common among women than men (54.5% vs. 12.9%) and greater with older age., Discussion: Excess body weight appears to be common in Iran. More women than men present with overweight and abdominal obesity. Prevention and treatment strategies are urgently needed to address the health burden of obesity.

Background: Various oral hypoglycemic agents have already been administered to type-2 diabetic patients to normalize their plasma glucose concentrations but they have not had complete and sustained success. In recent years, bromocriptine has been tried with controversial results. In present study, the effect of bromocriptine on glycemic control was evaluated in obese type-2 diabetic patients., Methods: In a double-blind placebo-controlled clinical trial, 40 obese patients with type-2 diabetes (aged 32-70 years) were randomly allocated to the two treatment groups. The first group received bromocriptine (2.5 mg daily) for a total of 3 months. The second group received placebo. They had been uncontrolled on fixed doses of glibenclamide or its combination with metformin in the 3 months before enrolling in the study. The fasting plasma glucose (FPG) level and glycosylated hemoglobin (HbA1) were measured and body mass index (BMI) was calculated before and 1, 2 and 3 months after treatment., Results: The FPG level decreased in the bromocriptine-treated group from 10.59 +/- 0.42 to 9.06 +/- 0.41 mmol/l (mean +/- SEM; p < 0.01), whereas in the placebo group it was not changed, 10.69 +/- 0.52 and 10.6 +/- 0.57 mmol/l, respectively. The HbA1 concentration was reduced in the bromocriptine-treated group from 9.9 +/- 0.3 to 9.5 +/-0.2% (p = 0.06), whereas it increased in the placebo-treated group from 10.2 +/- 0.3 to 11.3 +/- 0.6% (p < 0.05). The differences in HbA1 (1.8%, p < 0.01) and FPG (1.55 mmol/l, p < 0.05) levels between the bromocriptine and placebo groups at 3 months were significant. No changes in body weight or BMI occurred during the study in either placebo- or bromocriptine-treated group., Conclusion: The data further support the contention that bromocriptine improves glycemic control in obese type-2 diabetic patients, although the mechanism of action remains to be determined.

Background: Various oral hypoglycemic agents have already been administered to type-2 diabetic patients to normalize their plasma glucose concentrations but they have not had complete and sustained success. In recent years, bromocriptine has been tried with controversial results. In present study, the effect of bromocriptine on glycemic control was evaluated in obese type-2 diabetic patients. Methods: In a double-blind placebo-controlled clinical trial, 40 obese patients with type-2 diabetes (aged 32–70 years) were randomly allocated to the two treatment groups. The first group received bromocriptine (2.5 mg daily) for a total of 3 months. The second group received placebo. They had been uncontrolled on fixed doses of glibenclamide or its combination with metformin in the 3 months before enrolling in the study. The fasting plasma glucose (FPG) level and glycosylated hemoglobin (HbA1) were measured and body mass index (BMI) was calculated before and 1, 2 and 3 months after treatment. Results: The FPG level decreased in the bromocriptine-treated group from 10.59 ± 0.42 to 9.06 ± 0.41 mmol/l (mean ± SEM; p < 0.01), whereas in the placebo group it was not changed, 10.69 ± 0.52 and 10.6 ± 0.57 mmol/l, respectively. The HbA1 concentration was reduced in the bromocriptine-treated group from 9.9 ± 0.3 to 9.5 ±0.2% (p = 0.06), whereas it increased in the placebo-treated group from 10.2 ± 0.3 to 11.3 ± 0.6% (p < 0.05). The differences in HbA1 (1.8%, p < 0.01) and FPG (1.55 mmol/l, p < 0.05) levels between the bromocriptine and placebo groups at 3 months were significant. No changes in body weight or BMI occurred during the study in either placebo- or bromocriptine-treated group. Conclusion: The data further support the contention that bromocriptine improves glycemic control in obese type-2 diabetic patients, although the mechanism of action remains to be determined. Copyright © 2004 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Aim To determine the progression rates from metabolically healthy or unhealthy normal weight, overweight and obese phenotype to type 2 diabetes (T2D) in a non-diabetic high risk population in Isfahan, Iran. Methods T2D incidence during a mean (SD) follow-up of 10.1 (2.3) years was examined among 1,982 non-diabetic first-degree relatives (FDR) of patients with T2D 30–70 years old. Participants were divided into 6 groups based on body mass index and metabolic syndrome component, except waist circumference, at baseline: metabolically healthy normal weight (MHNW), metabolically healthy overweight (MHOW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUNW), metabolically unhealthy overweight (MUOW) and metabolically unhealthy obese (MUO). Results The MHO, MUOW, and MUO individuals at baseline were associated with incidence of T2D, independently of age and gender. MHO were 3 times (OR 2.96; 95% CI 1.07, 8.24) and MUOW were 2.75 times (95% CI 1.17, 6.45) more likely to develop T2D than those with MHNW. There was excess risk in MUO than MHO (OR 3.86; 95% CI 1.64, 9.11). Conclusions Obesity was a risk factor for T2D, even in the absence of any metabolic abnormalities. Metabolic abnormalities were a stronger predictor of incident T2D than obesity. [ABSTRACT FROM AUTHOR]

Aim The present study was designed to estimate the progression rates from combination of normal weight, overweight, obesity, and number of metabolic abnormalities (MA) to type 2 diabetes (T2D) in a non-diabetic high risk population in Isfahan, Iran. Methods A total of 1869 non-diabetic first-degree relatives (FDR) of patients with T2D 30–70 years old were examined and followed for a mean (SD) of 7.3 (2.2) years for T2D incidence. At baseline and through follow-up, participants underwent a standard 75-g 2-h oral glucose tolerance test. Results The metabolically healthy overweight and obese at baseline were associated with incidence of T2D, independently of age and gender. Any one MA increased the risk of developing T2D among normal weight, overweight and obese individuals. Those with normal weight and ≥3 MA were over 20 times (odds ratios (OR) 20.21; 95% confidence intervals (CI) 2.4, 170.4) and those with overweight and ≥3 MA 22.5 times (OR 22.5; 95% CI 3.0, 167.0) and obese with ≥3 MA were 25.4 times (OR 25.4; 95% CI 3.4, 187) more likely to develop T2D than those with normal weight and without MA. Compared with participants without MA, obese individuals with concomitant MA were not significantly more likely to progress to T2D. Conclusion Our data provide further evidence that normal weight, overweight and obese individuals with MA had a higher risk of incident T2D than normal weight individuals without MA. [ABSTRACT FROM AUTHOR]

Summary: Objectives: The aim of this study was to compare the ability of the body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-stature ratio (WSR) to predict progression to diabetes in non-diabetic first-degree relatives (FDRs) of patients with type 2 diabetes. Methods: A total of 704 non-diabetics FDRs 20–70 years old in 2003–2005 were followed through 2008 for the occurrence of type 2 diabetes mellitus. At baseline and through follow-ups, participants were underwent a standard 75g 2-h oral glucose tolerance test. Prediction of progression to type 2 diabetes was assessed with area under the receiver operating characteristic (ROC) curves based upon measurement of BMI, WC, WHR and WSR. Results: The incidence of type 2 diabetes was 3.3% per year in men and 4.8% in women. BMI, WC and WSR were related to diabetes. These three obesity indicators have similar associations with incident diabetes. Areas under the ROC curves were 0.625 for BMI, 0.620 for WC, 0.611 for WSR and 0.538 for WHR. Conclusions: These data indicate that BMI was as strong as WC or WSR in predicting progression to diabetes. [Copyright &y& Elsevier]