Prevalence and trend of multiple coronary artery disease risk factors and their 5-year incidence rate among adult population of Kerman: results from KERCADR study.

BACKGROUND: Coronary artery diseases (CADs) are the most important non­communicable diseases (NCDs), which cause the highest number of deaths around the world. Hypertension (HTN), dyslipidemia (DL), diabetes mellitus (DM), obesity (OB), low physical activity (LPA), smoking, opium consumption (OC) and anxiety are the most important CAD risk factors, which are more dangerously present in combination in some patients. METHODS: A total of 5835 people aged 15 to 75 years were enrolled in the phase 1 (2012) and followed up to the phase 2 (2017) of the population-based Kerman coronary artery diseases risk factors study (KERCADRS). The prevalence and pattern of different combinations of CAD risk factors (double to quintuple) and their 5-year incidence rates were assessed. RESULTS: The prevalence of single CAD risk factors (RFs) in phase 2 was 50.2% (DL), 47.1% (LPA), 28.1% (abdominal obesity), 21.2% (OB), 16.5% (HTN), 9.2% (smoking), 9.1% (OC), and 8.4% (DM). The most frequent combination of risk factors was LPA plus DL (23.9%), metabolic syndrome (19.6%), and DL plus OB (17.8%). The 5-year incidence rates of multiple comorbidities (in persons per 100 person-years) was DL plus LPA (2.80%), HTN plus DL (1.53%), and abdominal obesity (AOB) plus DL (1.47%). The most participants (84.4%) suffered from at least one RF, while 54.9% had at least two and 29.9% had at least three RFs. CONCLUSION: The results showed that a large portion of the study population suffers from multiple CAD RFs. The findings underscore the importance of identifying multiple CAD risk factors to reduce the overall burden of these NCDs.

Prevalence, Incidence and Health Impacts of Sleep Disorders on Coronary Artery Disease Risk Factors: Results of a Community-Based Cohort Study (KERCADRS).

Objective: Sleep disorders are associated with many health problems including anxiety, depression and coronary artery disease (CAD). This study investigated the prevalence, predictors and health impacts of insomnia and hypersomnia in southeastern Iran as well as the five-year incidence rate (IR) of these sleep disorders. Method : The present study was a cross-sectional, single-stage, cluster sampling study examining nine CAD risk factors (KERCADR study phase two), including sleep disorders, carried out in Kerman on 9997 participants, 15 to 80 years old. Medical examination along with demographic, sleep status, Physical activity level (GPAQ), anxiety and depression status (Beck Inventories) were assessed and fasting blood sample was taken for blood glucose and lipids analysis. STATA v15 software was used for data analysis using survey data analysis package and a univariable survey logistic regression model. Results: From 9997 participants, 59.4% were female. 45.3% of the participants were suffering from insomnia and hypersomnia, which was 15% more than the phase 1 prevalence (P < 0.001). Participants with insomnia had higher chance of being anxious, but participants with hypersomnia had higher chance of being depressed, be a cigarette smoker, opium user, and sedentary (P < 0.001). In regards to marital status, prevalence of hypersomnia was as follows in ascending order of prevalence: singles > married > widowed > divorced. While the IR of insomnia was higher in females, males had higher IR of hypersomnia. In addition, the IR of both sleep disorders was higher in participants with Low Physical Activity (LPA). Conclusion: The results showed high current prevalence and increasing trends of sleep disorders in the past five years. If left unaddressed, burden of CVDs in the community will demonstrate a significant increase in the future as a result of sleep disorders and other associated risk factors.

Trends in the prevalence and incidence of anxiety and depressive symptoms in Iran: findings from KERCADRS.

OBJECTIVES: Anxiety and depression (A&D) are common mental disorders with high economical and health burdens. This study aimed to investigate the prevalence and the incidence rate of A&D symptoms and their relationship with sociodemographic and other risk factors and comorbidities in adults living in southeastern Iran. DESIGN: A population-based cohort study with random cluster household survey sampling method. SETTING: Second round of Kerman Coronary Artery Disease Risk Factors Study (KERCADRS) (2014-2018) performed in Southeastern, Iran. PARTICIPANTS: We recruited 9997 participants (15-80 years) in the second round of the study, from whom 2820 persons were the people who also participated in the first round of KERCADRS in 2009-2012. The age-standardised A&D prevalence was measured among all participants, and the 5-year A&D incidence rate was measured in those who were free from A&D in the first round in 2009-2012 and were at risk of A&D in the follow-up. The relationship between A&D and demographic characteristics, smoking, opium use, obesity and physical activity was assessed by logistic regression models. RESULTS: Overall, the prevalence of anxiety (48.1% to 16.4%, p<0.001) and depression (5.9% to 1.3%, p<0.001) decreased between the two rounds. The highest prevalence of anxiety was among widowed (31.4%), unemployed (21.3%), obese (19.4%), and opium users (17.4%). Young adults, women, those divorced or widowed, and those with obesity and low physical activity had a higher chance of developing anxiety. The 5-year incidence rate (person/1000 person-years) was 15.0 for anxiety and 3.9 for depression. CONCLUSION: Despite the overall decrease in the prevalence of A&D symptoms in last 5 years in the area, young adults, women, unemployed, opium users, people with low physical activity and those with obesity had a higher chance of developing anxiety and are in need of more targeted interventions.

Downregulation of IL-22 can be considered as a risk factor for onset of type 2 diabetes.

There is some controversy as for the roles played by tumor growth factor-ß (TGF-ß), interleukin-1ß (IL-1ß), and IL-22 in the onset process of type 2 diabetes (T2D). The main aim of this project was to examine serum levels of TGF-ß, IL-1ß, and IL-22 in the new cases and long period T2D patients as well as healthy controls. In this study, 115 new T2D patient cases (group 1), 434 T2D patients who have suffered from the disease more than 2 years (group 2), and 104 healthy controls have been selected from 6240 (3619 females) patients who were under study population from Kerman Coronary Artery Disease Risk Factor Study. Serum levels of TGF-ß, IL-1ß, and IL-22 have been evaluated using commercial kits. Serum levels of TGF-ß and IL-1ß significantly increased, while IL-22 decreased in 2 groups in comparison to healthy controls. Serum levels of IL-22, but not TGF-ß and IL-1ß, were significantly decreased in group 1 in comparison to healthy controls. There were no significant differences between groups 1 and 2 as for the cytokine levels. Serum levels of IL-22 increased in the females in group 2 when compared to females in group 1. It appears that TGF-ß and IL-1ß participate in the induction of inflammation after establishment of T2D, while decrease in IL-22 may be considered as a key factor for onset of the disease. Gender can also be considered as the main risk factor for variation in cytokine levels.

Overweight and obesity prevalence and its predictors in a general population: A community-based study in Kerman, Iran (Kerman coronary artery diseases risk factors studies).

BACKGROUND: The aim of this study was to present age-sex standardized prevalence of overweight and obesity as well as central obesity and its associated variables in an adult population of Iran. METHODS: Around 5900 adult individuals aged 15-75 years enrolled to the study from 2009 to 2011 applying randomized cluster household survey in Kerman, southeastern of Iran. Overweight was defined as body mass index (BMI) 25-29.9 kg/m2, obesity was considered as BMI ≥ 30 kg/m2, and central obesity was regarded as waist circumference (WC) > 88 cm for women and 102 cm for men. RESULTS: The overall age-sex standardized prevalence of overweight, obesity and central obesity was 29.6% (29.5% men, 29.7% women), 13.0% (9.3% men, 16.9% women) and 14.4% (7.5% men, 21.5% women), respectively. "Overweight/obesity" increased by age, [adjusted odds ratio (AOR): 7.9 95% confidence interval (CI): 5.8, 10.7)] for 65-75 years old, 11.7 (95% CI: 9, 15.3) for 55-65 years old, 10.1 (95% CI: 7.8, 13) for 45-54 years old compared with the first age group), female gender [AOR: 1.5 (1.3, 1.8); P < 0.001], higher education (AOR > 1.5 compared with illiterate individuals; P < 0.001), and low physical activity [AOR: 1.4 (95% CI: 1.1, 1.8); P = 0.006] and decreased by smoking [AOR: 0.4 (95% CI: 0.3, 0.6); P < 0.001] and opium using [AOR: 0.5 (95% CI: 0.4, 0.7); P < 0.001]. Female gender [AOR: 4.1 (95% CI: 3.3, 5); P < 0.001], advanced (AOR > 7 for age groups ≥ 35 years old; P < 0.001) positively, while smoking [AOR: 0.6 (0.4, 0.8); P = 0.004] negatively were the most significant predictors for abnormal WC. CONCLUSION: Our data reveal that overweight and obesity affected almost half of the adult population (43.0%), and central obesity was around 15.0%, which reflect the high prevalence of this abnormality. In addition, several demographic, social and lifestyle factors were associated with obesity. Appropriate interventions and strategies with a concentration of the general population are needed to deal with its potential subsequent consequences.

Association of oral health and cardiovascular disease risk factors "results from a community based study on 5900 adult subjects".

Objectives. This study aimed to determine the association between some oral health status as a risk factor for cardiac diseases and other cardiovascular disease (CVD) risk factors in a sample of Iranian population in 2011. Methods. The study recruited 5900 inhabitants who aged 15-75 years old of Kerman city through a population based cluster sampling. Having collected informed consent, participants were interviewed for CVD risk factors. Some oral health indicators such as DMFT, Gingival Inflammation index, and Community Periodontal Index were assessed. The association between oral health indices and CVD risk factors was tested using multivariate regression models. Results. The mean age of participants was 33.5 years, and 45.1% were male. Moderate gingival inflammation was observed in 67.6% of participants. Presence of sub- or supragingival calculus was more common (90%) in participants. Older age (RR from 2.7 to 3.88), cigarette smoking (RR = 1.49), and high blood glucose (RR = 1.41) showed an increased risk for oral diseases after adjustment for different covariates including established CVD risk factors. Conclusion. The study results showed an increase in periodontal diseases in the presence of some CVD risk factors. Therefore there may be a bilateral but independent association for both conditions and common risk factor approach preventive program is highly recommended.