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Objective: Diabetes is an important risk factor for cardiovascular disease. The purpose of this study was to explore the role of diabetes and prediabetes in the risk of cardiovascular disease. Methods: This prospective study was performed on three groups of non-diabetic (n = 7291), prediabetic (n = 438), and diabetic (n = 1713) in the age range of 40–70 years in Kharameh (Iran) in 2014–2021. The participants were followed for 4 years. Demographic information, chronic disease history, behavioral habits, and laboratory parameters were examined. Initially, the incidence density was calculated and the difference between the risk of cardiovascular disease in the three groups was examined using the log-rank test. The Cox regression model was performed to investigate the association between prediabetes and diabetes with the risk of cardiovascular disease. Results: The mean age of the participants was 51.47 years. The density incidence in the three groups of non-diabetic, prediabetic, and diabetic individuals was estimated to be 1.5, 1.5, and 3.9 cases per 100,000 person-days, respectively. There was no statistically significant relationship between prediabetes and the incidence of cardiovascular disease. However, the incidence of cardiovascular disease in diabetics was 2.55, 2.16, and 2 times higher than in non-diabetics in the simple, adjusted for age and sex, and in multiple Cox regression, respectively. Conclusion: Due to the independent role of diabetes in the incidence of cardiovascular disease, diabetic individuals should be screened periodically for cardiovascular conditions. Furthermore, it is very important for these individuals to control the important risk factors that contribute to the incidence of cardiovascular disease. [ABSTRACT FROM AUTHOR]

Background and Aims: Declines in estradiol levels after menopause have been reported to be associated with several health outcomes. This study aimed to determine the effect of age at natural menopause (ANM) on some of the most common chronic diseases. Methods: This historical cohort study was performed on 2636 postmenopausal women aged 40–70 years participating in phase one of the PERSIAN cohort study in Kharameh, Iran, during 2015–2017. The effect of early (<45 years), intermediate (45–53 years), and late menopause (>53 years) on chronic diseases such as hypertension, diabetes, ischemic heart diseases, stroke, thyroid diseases, and depression was assessed using classic logistic regression for diseases with an incidence rate of more than 10% and Firth's logistic regression for diseases with an incidence of less than this amount. Results: The mean age of women was 53.48 ± 8.59. Respectively, early and intermediate menopause was associated with ischemic heart disease (odds ratio [OR = 1.61, 95% confidence interval [CI]: 1.08–2.42; p = 0.020), (OR = 1.57, 95% CI: 1.13–2.21; p = 0.008) and thyroid diseases (OR = 3.10, 95% CI: 1.64–6.24; p < 0.001), (OR = 1.83, 95% CI: 1.02–3.57; p = 0.042). furthermore, early menopause was a risk factor for diabetes (OR = 1.46, 95% CI: 1.07–2.00; p = 0.018), depression (OR = 4.79, 95% CI: 2.20–11.79; p = <0.001) and stroke (OR = 3.00, 95% CI: 1.08–9.32; p = 0.034). Conclusions: In this study, women with diabetes, ischemic heart diseases, stroke, thyroid disorders, and depression had a younger ANM compared to their healthy counterparts. Therefore, applying appropriate strategies to postpone the age of menopause, can reduce the incidence of these types of chronic diseases. [ABSTRACT FROM AUTHOR]

Background: A comprehensive strategy to reduce the complications of hypertension (HTN) should include prevention approaches, such as increasing awareness, early diagnosis, and adequate treatment. The present study aimed to assess awareness, treatment, and control of HTN and their related factors in Kherameh, Iran. Methods: This cross-sectional study was performed on 10 663 individuals aged between 40 and 70 years using the Kherameh cohort data. HTN was defined as either systolic/diastolic blood pressure ≥140/90 mmHg or taking medications. Logistic regression was used to investigate the relationship between awareness, treatment, and control of HTN and demographic factors, comorbidities, and a family history of diseases. Results: Out of 10 663 participants, 4719 (44.3%) were men, and the average age of the participants was 51.94±8.27 years. The rates of the prevalence, awareness, treatment, and control of HTN were 27.7% (95% CI, 26.86 to 28.54), 80.3% (95% CI, 79.56 to 81.04), 78% (95% CI, 77.22 to 78.78), and 53.6% (95% CI, 52.66 to 54.54), respectively. Age, gender, body mass index, and cardiovascular disease were associated with all the dependent variables in the regression model. Additionally, occupation, diabetes, chronic diseases, a history of cardiovascular disease in first and second-degree relatives and a history of chronic diseases in second-degree relatives were related to all the dependent variables except for treatment. Conclusion: A high percentage of the patients were aware of their disease, but a smaller proportion were on medication. Consequently, about half the patients had blood pressure below 140/90 mmHg. [ABSTRACT FROM AUTHOR]

Background: The trend of chronic diseases is increasing globally. Socioeconomic status (SES) is a major factor underlying many chronic diseases. This study was conducted to investigate the socioeconomic inequalities in distribution of chronic diseases in Iran, as a middle-income country. Methods: This cross-sectional study was conducted using the baseline data of the Kharameh cohort study, that were collected between 2014 and 2016. The number of participants in this study was 10 663 people in the age range of 35 to 70 years. Principal component analysis was used for calculating the SES of the people under study. In addition, we used concentration index and concentration curve to measure socioeco nomic inequality in chronic disease. Results: The mean age of 10,663 participants in our study was 52.15 ± 8.22 years and the male to female ratio was 1.26. Recurrent headache (25.8%( and hypertension (23.5%) were the most prevalent diseases. The concentration index showed that the distribution of movement disorder, recurrent headaches and gastroesophageal reflux diseases is significantly concentrated among people with low SES, and obesity among people with high SES. The results of the analysis by gender were similar to the results seen in all participants. Conclusion: The findings of this study show that socioeconomic inequality is the cause of the concentration of non-communicable diseases among people with low socio-economic status. Therefore, health policy makers should pay special attention to identifying vulnerable subgroups and formulate strategic plans to reduce inequalities. [ABSTRACT FROM AUTHOR]

Background: Ductal carcinoma in situ (DCIS) is widely recognized as the precursor of invasive ductal carcinoma (IDC). We aimed to compare clinicopathological characteristics and prognosis between IDC with and without coexisting DCIS stratified by biological subtypes to evaluate the clinical outcome of these two groups. Method: Data from 5814 patients with IDC (32.4) and IDC/DCIS (67.6%), who underwent surgery from December 1993 through December 2019, were retrospectively assessed. We evaluated the prognosis of IDC with coexisting DCIS in different molecular subtypes. Results: IDC/DCIS patients were younger (P < 0.001). They also presented with a low tumor grade and had less lymph node involvement compared with the pure IDC patients. Compared with the patients with IDC, luminal B subtype was more frequent in those with IDC/DCIS, with 19.4% versus 13.2 %; human epidermal growth factor receptor-2 enriched subtype was also more frequently observed, with 12.2 vs. 8.7%. The 5-year disease-free survival (DFS) was higher in the IDC/DCIS patients (P = 0.036). The survival outcomes significantly improved in the cases with a higher amount of DCIS. The presence of coexisting DCIS (P =0.038), tumor size (P < 0.001), lymph node status (P = 0.005), lymph vascular invasion (P = 0.02), and molecular subtypes (P < 0.001) were found to be DFS-associated independent prognostic factors. Conclusion: DCIS along with IDC were associated with improved prognosis. The presence of DCIS may be a marker of lower aggressiveness, and could be noticed as a prognostic factor in future treatment algorithms. [ABSTRACT FROM AUTHOR]

Purpose: In this study, the prevalence of diabetes and pre-diabetes (pre-DM) has been estimated; also, some factors related to diabetes and pre-diabetes in the city of Kharameh, southern Iran, were investigated. Methods: This cross-sectional study was conducted on a total of 10,474 subjects aged 40–70 years who participated in phase one of PERSIAN Kharameh cohort carried out between 2015 and 2016. Eligible individuals were included in the study by census method. Results: Prevalence of diabetes is 20.17% (95% CI: 19.95–20.39) and that of pre-diabetes is 15.74% (95% CI 15.54–15.93). Multivariate logistic regression results showed that the prevalence of diabetes had a direct relationship with increasing age (p < 0.001), being single (p = 0.005), family history of diabetes (p < 0.001), abdominal obesity (p < 0.001), hypertension (p: < 0.001), and high triglycerides (p: < 0.001); also, it had an inverse relationship with residence in rural areas (p < 0.001), education (p < 0.001), and employment (p < 0.001). Also, the prevalence of pre-diabetes showed a direct relationship with increasing age (60–70 years p = 0.010), being single (p = 0.004), living in rural areas (P < 0.001), having a family history of diabetes (both P = 0.023), abdominal obesity (P < 0.001), hypertension (P < 0.001), high cholesterol (P < 0.001) and high triglycerides (P < 0.001), and an inverse relationship with female gender (P < 0.001), education (high school P = 0.022), employment (P = 0.010), and smoking habit (P = 0.019). These results were all statistically significant. Conclusion: The present study shows the high prevalence of diabetes and pre- diabetes in the city of Kharameh. Diabetes prevention policies should be developed and implemented for the public. [ABSTRACT FROM AUTHOR]

Background: So far, no comprehensive studies have been performed to assess burden and determinants of anemia in Iran. In the present study, we aimed to answer this query using the data obtained from the Prospective Epidemiological Research Studies in IrAN (PERSIAN). Methods: In this cross-sectional study, we included 161,686 adult participants (aged 35 years and older) from 16 provinces of Iran. Anemia was defined as a hemoglobin concentration of <13 g/dL in males and <12 g/dL in females. To evaluate the association between anemia and different factors, we used the multivariable Poisson regression analysis with robust variance by applying adjusted prevalence ratio (PR) with 95% confidence interval (CI). Results: Of the total number of subjects, 72,387 (44.77%) were male and others were female. Mean age was 49.39±9.15 years old. The overall age- and sex-standardized prevalence of anemia was 8.83% (95% CI: 8.70–8.96%) in the included population. The highest and the lowest age- and sex-standardized prevalence of anemia pertained to Hormozgan (37.41%, 95% CI: 35.97–38.85%) and Kurdistan (4.57%, 95% CI: 3.87–5.27%) provinces, respectively. Being female (PR = 2.97), rural residence (PR = 1.24), being retired (PR = 1.53) and housewife (PR = 1.11), third and fourth wealth status quartiles (PR = 1.09 and PR = 1.11, respectively), being underweight (PR = 1.49), drug user (PR = 1.35), inadequate sleep (PR = 1.16), poor physical activity (PR = 1.15), diabetes (PR = 1.09), renal failure (PR = 2.24), and cancer (PR = 1.35) were associated with increased risk of anemia. On the other hand, illiteracy (PR = 0.79) and abdominal obesity (PR = 0.77) decreased the risk of anemia. Conclusions: According to the results, a variable prevalence of anemia was observed across the included provinces. We tried to provide an informative report on anemia prevalence for health professionals and authorities to take measures for identification and management of the cases of anemia in high-prevalence areas. [ABSTRACT FROM AUTHOR]

Background: Bronchus and lung cancer (BLC) is the first most prevalent cancer in terms of incidence and mortality worldwide. It is estimated that the number of new BLC cases will rise up to 15 million per year by 2020. Method: We conducted this study using the data obtained from Fars Population Based Cancer Registry (FPBCR). The National Institute of Statistics (NIS) website provided the population data on Fars province. Additionally, we calculated the ASR through the WHO's standard population 2000. The standardized rates were calculated via R software and the rate trends were analyzed using chi-square test. Result: Over a 5-year period (2011-2015), 1466 new BLC cases were registered in Fars province, 1009 men (68.8%) and 437 women (31.2%). BLC was amongst the first 10 most prevalent cancers in both genders. The annual incidence rate of BLC was defined to be 7.69-10.78 per 100,000 among men and 3.00-4.52 per 100,000 among women. Conclusion: BLC is amongst the most prevalent cancers with geographical variations in incidence rates. Consistent with cancer reports from other province, relatively high rates of BLC were observed in Fars province, particularly among men. [ABSTRACT FROM AUTHOR]

Objective: Cardiovascular diseases (CVDs) are the most common cause of death worldwide. Diet plays an important role among many risk factors for CVDs. The present study aimed to investigate the relationship between carbohydrate quality index (CQI) and conventional risk factors of CVDs in Iranian adults., Results: A higher CQI was related to a higher intake of energy, fiber, whole grains, fruits, vegetables, nuts, legumes, and dairy products. Additionally, a significant negative association was observed between CQI and triglycerides (TG) (odds ratio (OR) = 0.85; 95% confidence interval (CI): 0.73-0.98, highest versus the lowest tertile, p for trend = 0.026) and non-high density lipoprotein cholesterol (non-HDL-C) (OR = 0.85; 95% CI: 0.75-0.96, highest versus the lowest tertile, p for trend = 0.012). No significant correlation was shown between CQI and other cardiovascular risk factors. The findings indicate that the CQI is inversely associated with TG and non-HDL-C. Further studies are proposed to confirm these findings., (© 2024. The Author(s).)

Background: Elevated blood pressure is associated with cardiovascular disease, stroke and chronic kidney disease. In this study, we examined the socioeconomic inequality and its related factors in prevalence, Awareness, Treatment and Control (ATC) of hypertension (HTN) in Iran., Method: The study used data from the recruitment phase of The Prospective Epidemiological Research Studies in IrAN (PERSIAN). A sample of 162,842 adults aged >  = 35 years was analyzed. HTN was defined according to the Joint National Committee)JNC-7(. socioeconomic inequality was measured using concentration index (Cn) and curve., Results: The mean age of participants was 49.38(SD =  ± 9.14) years and 44.74% of the them were men. The prevalence of HTN in the total population was 22.3%(95% CI: 20.6%; 24.1%), and 18.8%(95% CI: 16.8%; 20.9%) and 25.2%(95% CI: 24.2%; 27.7%) in men and women, respectively. The percentage of awareness treatment and control among individuals with HTN were 77.5%(95% CI: 73.3%; 81.8%), 82.2%(95% CI: 70.2%; 81.6%) and 75.9%(95% CI: 70.2%; 81.6%), respectively. The Cn for prevalence of HTN was -0.084. Two factors, age (58.46%) and wealth (32.40%), contributed most to the socioeconomic inequality in the prevalence of HTN., Conclusion: The prevalence of HTN was higher among low-SES individuals, who also showed higher levels of awareness. However, treatment and control of HTN were more concentrated among those who had higher levels of SES, indicating that people at a higher risk of adverse event related to HTN (the low SES individuals) are not benefiting from the advantage of treatment and control of HTN. Such a gap between diagnosis (prevalence) and control (treatment and control) of HTN needs to be addressed by public health policymakers., (© 2022. The Author(s).)