Sex-specific prevalence of coronary heart disease among Tehranian adult population across different glycemic status: Tehran lipid and glucose study, 2008–2011

Abstract

Background Coronary heart disease (CHD) is one of the leading causes of death. Alarmingly Iranian populations had a high rank of CHD worldwide. The current study aimed to assess the prevalence of CHD across different glycemic categories. Methods This study was conducted on 7718 Tehranian participants (Men = 3427) aged ≥30 years from 2008 to 2011. They were categorized based on glycemic status. The prevalence of CHD was calculated in each group separately. CHD was defined as hospital records adjudicated by an outcome committee. The association of different glycemic categories with CHD was calculated using multivariate logistic regression, compared with normal fasting glucose /normal glucose tolerance (NFG/NGT) group as reference. Results The age-standardized prevalence of isolated impaired fasting glucose (iIFG), isolated impaired glucose tolerance (iIGT), both impaired fasting glucose and impaired glucose tolerance (IFG/IGT), newly diagnosed diabetes mellitus (NDM), and known diabetes mellitus (KDM) were 14.30% [95% confidence interval (CI): 13.50–15.09], 4.81% [4.32–5.29], 5.19% [4.71–5.67], 5.79% [5.29–6.28] and 7.72% [7.17–8.27], respectively. Among a total of 750 individuals diagnosed as cases of CHD (398 in men), 117 (15.6%), 453 (60.4%), and 317 (42.3%) individuals had a history of myocardial infarction (MI), cardiac procedure, and unstable angina, respectively. The age-standardized prevalence of CHD for the Tehranian population was 7.71% [7.18–8.24] in the total population, 8.62 [7.81–9.44] in men and 7.19 [6.46–7.93] in women. Moreover, among diabetic participants, the age-standardized prevalence of CHD was 13.10 [9.83–16.38] in men and 10.67 [8.90–12.44] in women, significantly higher than corresponding values for NFG/NGT and prediabetic groups. Across six levels of glycemic status, CHD was associated with IFG/IGT [odds ratio (OR) and 95% CI: 1.38 (1.01–1.89)], NDM [1.83 (1.40–2.41)], and KDM [2.83 (2.26–3.55)] groups, in the age- and sex-adjusted model. Furthermore, in the full-adjusted model, only NDM and KDM status remained to be associated with the presence of CHD by ORs of 1.40 (1.06–1.86) for NDM and 1.91 (1.51–2.43) for KDM. Conclusion The high prevalence of CHD, especially among diabetic populations, necessitates the urgent implementation of behavioral interventions in the Tehranian population, according to evidence-based guidelines for the clinical management of diabetic patients.

A Response to the Letter to the Editor Regarding “Nationwide Prevalence of Diabetes and Prediabetes and Associated Risk Factors Among Iranian Adults: Analysis of Data from PERSIAN Cohort Study” to the end of Study

“…Moreover, the prevalence of prediabetes was 25.8% [ 5 ]. In addition, the authors of the letter to the editor confirmed that the reported prevalence of our study is comparable to their result in Tehran [ 6 ]. It should be noted that methods and instruments for recording fasting plasma glucose (FPG) were not the same across different iterations of STEPS surveys, while laboratory methods followed unified protocols and instruments for measuring FPG across the PERSIAN cohort centers.…”

Letter to the Editor Regarding “Nationwide Prevalence of Diabetes and Prediabetes and Associated Risk Factors Among Iranian Adults: Analysis of Data from PERSIAN Cohort Study”

“…In their study, using fasting blood sugar criteria, they found that about 40.40% of the participants had dysglycemia (i.e., impaired fasting plasma glucose or diabetes). This finding is supported by our recent study performed in the metropolitan city of Tehran between 2008 and 2011, which showed that only 62.20% of Tehranian adults had normal glucose tolerance, based on strict criteria [ 2 ].…”

Iranian National Clinical Practice Guideline for Exercise in Patients with Diabetes

“…According to a 2016 report by the World Health Organization (WHO), the prevalence of diabetes in Iran was 10.3% (5). However, the crude prevalence of prediabetes and diabetes among the adult population of Tehran may have been up to 26.43 and 16.27%, respectively (6). Type 2 and type 1 diabetes comprise 85.5 and 11.4% of the registered Iranian population with diabetes, respectively, and the remaining suffer from the other types of the disease (7).…”