A cluster of risk factors for cardiovascular diseases and type 2 diabetes mellitus, which occur together more often than by chance alone, have been known as the metabolic syndrome. Various definitions have been proposed by different organizations over the past decade. This study was designed to evaluate a new definition of the metabolic syndrome for the prediction of diabetes mellitus among the Iranian population. This study was carried out in an urban population, aged 20 to 74 years, from Yazd, a city in the center of Iran. The study is a part of the phase I of Yazd Healthy Heart Program, that is, a community-based intervention study for the prevention of cardiovascular disease. The significance level has been defined as P<0.05. Prevalence of the metabolic syndrome by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria was 21.3 ± .017%, and by International Diabetes Federation (IDF) criteria it was 30.16 ± .02%. The multivariate analysis showed that the most important relevant factors of diabetes mellitus were: Increased age and metabolic syndrome by both definitions of NCEP and IDF criteria, and also, the most important relevant factors of stable angina were: Increased age, male sex, and metabolic syndrome by only IDF definitions, but the NCEP definition of the metabolic syndrome cannot predict diabetes mellitus independent of age and sex. This study showed that increased age and metabolic syndrome are the most important relevant factors for diabetes mellitus, especially by using the IDF criteria for definition of the metabolic syndrome.

Background: There is a substantial disparity in coronary artery disease (CAD) burden between Iran and other nations that place a strong emphasis on the assessment of CAD risk factors and individuals’ awareness and ability to control them. Methods: Two thousand participants of a community-based Iranian population aged 20–74 years were investigated with a mean follow-up of 9.9 years (range: 7.6 to 12.2). An analysis of Cox regression was conducted to determine the association between CAD development and classic risk factors such as age, sex, smoking, physical activity, education, obesity, dyslipidemia, hypertension, and diabetes mellitus. Furthermore, we computed the population attributable fraction for these risk factors. Results: After a follow-up period of nearly 10 years, 225 CAD events were reported, constituting 14.5% of the overall incidence. Nighty three percent of participants had more than one risk factor. Age was the most predictive risk factor, with a hazard ratio (HR) and confidence interval (CI) of 5.56 (3.87–7.97, p < 0.001) in men older than 45 and females older than 55 compared to lower ages. In comparison to females, males had an HR of 1.45 (CI: 1.11–1.90, p value = 0.006) for developing CAD. Nearly 80% of the patients had dyslipidemia, with a hazard ratio of 2.19 (CI: 1.40–3.44, p = 0.01). Among the participants, 28.9% had hypertension, and 52% had prehypertension, which had HRs of 4.1 (2.4–7.2, p < 0.001) and 2.4 (1.4–4.2, p < 0.001), respectively. Diabetes, with a prevalence of 17%, had an HR of 2.63 (CI: 2 -3.47, p < 0.001), but prediabetes was not significantly associated with CAD. Awareness of diabetes, dyslipidemia, and hypertension was 81%, 27.9%, and 48.1%, respectively. Regarding medication usage, the corresponding percentages were 51% for diabetes, 13.2% for dyslipidemia, and 41% for hypertension. Conclusions: Compared to previous studies in Iran and neighboring countries, the current study found a higher incidence of CAD, more prevalent risk factors, and a lower awareness and ability to control these risk factors. Thus, an effective preventive strategy is needed to reduce the CAD burden in Iran.

Background: Concerning ascending trend in the prevalence of chronic type II diabetes, prevention and the development of an effective approach after the recognition of at-risk individuals is crucial. This study aims to investigate comparing the influence of lifestyle modification and metformin interventions in the prevention of type II diabetes developments. Method: The search was conducted using PubMed, Google Scholar, Scopus and Web of Science databases. The inclusion criteria include randomized controlled trials (RCT) which studied both lifestyle modification and metformin interventions in the population above 18 years old without a history of any type of diabetes. After excluding studies with intervention time of fewer than 6 months, a systematic review and meta-analysis were performed to evaluate relative risk (RR) with a confidence interval (CI) of 95% of type II diabetes development. Results: Data from 5 studies were included in the meta-analysis. The population also consists of individuals with a mean age of 50 years old with BMI and FBS of 35.5 and 104.7 mg/dl respectively. Participants range of prevention years was between 2–3 years with a mean of 2.8 years. Lifestyle modification decreases the probability of the incidence of type II diabetes by 25.3% (RR: 0.747, 95% CI, 0.6—0.92) compared to the metformin intervention (p-value = 0.007). Our results indicate that long-term lifestyle modifications can prevent diabetes type II and decrease diabetes mellitus incidence down to one-quarter in comparison to metformin. Conclusion: Lifestyle modification can be more efficacious than metformin in diminishing the incidence of type II diabetes. Therefore, lifestyle modification can be a therapeutic strategy for controlling type II diabetes incidence, especially in high-risk individuals.

The study on natural substances especially, dietary components such as liquid oils affecting cholesterol can be important for therapeutic propose. Sesame seeds with various biomedical actions can be control the hypercholesterolemia. On the other hand, olive oil has a wide range of therapeutic effect on lipid profile in human. The aim of this study is to evaluate and compare lipid profile changes after olive and sesame oils consumption in hypercholesterolemia. This study was a clinical randomized trial that was performed via parallel design on 48 patients. The patients were randomly allocated in to two groups: A: olive oil and B: sesame oil. After 1 month prescription of Step I National Cholesterol Education Program diet, patients consumed 4 table spoons aprox. 60 g) of refined olive or sesame oil daily as an exchange of other oils, for 1 month. Lipid profiles The P < 0.05 was considered as significant difference. Out of 48 patients, 24 (50%) were men. The mean age was 41.7 ± 8.3 years. The mean of total cholesterol, triglyceride (TG), low density lipoprotein (LDL), cholesterol, and high density lipoprotein (HDL) cholesterol, before oil consumption was 224.5 ± 22, 256 ± 132, 132.6 ± 9, and 44.5 ± 11 mg/dl. After olive oil consumption cholesterol, TG, LDL-C, weight, waist and BMI were decreased and HDL-C was increased. After sesame oil consumption cholesterol, TG, LDL-C were significantly decreased. Weight, waist were decreased and HDL-C was increased (P > 0.05). Sesame oil had equivalent effect on lipid profile in comparison olive oil and lipid profile improvement was better in sesame oil in LDL-C and TG.

To assess the epidemiological characteristics of hypertensive patients in urban population of Yazd, A central city in Iran. This cross sectional study was conducted from 2005–2006 and carried out on population aging 20–74 years. It is a part of the phase I of Yazd healthy heart program that it is a community interventional study for prevention of cardiovascular disease. Data obtained from questionnaires were analyzed by SPSS version 13. P value less than 0.05 were considered significant level. This study comprised of 2000 participants that 847 (42.5%) were diagnosed as being hypertensive. After age adjustment, prevalence of hypertension was 25.6% (23.3% for women and 27.5% for men (P< 0.001). Age, Total cholesterol, LDL-cholesterol, triglyceride, fasting blood glucose, impaired glucose tolerance test, body mass index and waist were significantly higher in the hypertensive groups. 53.7% of hypertensive cases were aware of own condition, 45% were treated, and 33.9% of treated were controlled (30.7% and 35.4% in men and women respectively). In other word, 24% of all hypertensives (aware or unaware about own blood pressure condition) were treated and only 8% of them were controlled. Men significantly had less awareness (P< 0.001), lower tendency to take medication (P< 0.001), and less were controlled (P= 0.046). We understand high prevalence, low awareness, treatment, and control of hypertension and higher prevalence of other traditional metabolic risk factors in these cases. It seems that urgent preventional studies should be conducted in this population.

Background: Metabolic syndrome (MetS) is one of the world's largest health epidemics, and its management is a major challenge worldwide. The aim of this 10-year follow-up study was to assess the most important predictors of MetS persistence among an Iranian adult population. Methods: In this cohort study, 887 out of 2000 participants with MetS aged 20–74 years in the central part of Iran were followed-up for about 10 years from 2005–2006 to 2015–2016. MetS was defined based on the criteria of NCEP-ATP III adopted for the Iranian population. Cox proportional hazards regression was conducted to evaluate the predictors of MetS persistence in crude- and multivariate-adjusted models. Results: Our analyses showed that 648 out of 887 participants (73%) completed the follow-up and 565 (87.2%) of them had persistence of MetS after 10-year follow-up. There was a significant association between age, weight, body mass index, triglyceride, and waist circumference in participants who had MetS compared to those without MetS after 10-year follow-up (P < 0.05). There was a direct association between increases in the mean changes of systolic/diastolic blood pressure, waist circumference, and low HDL-C and risk of MetS persistence after adjusting the model for sex and age in the total population (P _trend < 0.05). The trends were the same for women except in diastolic blood pressure. After adjustment for potential confounders, the risk of MetS persistence in men was significantly higher than women (HR = 1.98, 95% CI: 1.38–2.85, Ptrend = 0.001). Conclusions: Most of the risk factors of MetS were positively associated with persistence of MetS. Therefore, modification of lifestyle is recommended to reduce MetS.