Kelishadi Roya, Heshmat Ramin, Farzadfar Farshad, Esmaeil Motlag Mohammad, Bahreynian Maryam, Safiri Saeid, Ardalan Gelayol, Rezaei Darzi Ehsan, Asayesh Hamid, Rezaei Fatemeh, Qorbani Mostafa
Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Noncommunicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
J Cardiovasc Thorac Res. 2017;9(1):12-20. doi: 10.15171/jcvtr.2017.02. Epub 2017 Mar 13.
The aim of the present study is to explore the prevalence and mean of cardiometabolic risk factors and liver enzymes of Iranian adolescents living in regions with different socioeconomic status (SES). To the best of our knowledge this is the first study reporting these data at sub-national level in Iran. This multi-centric study was performed in 2009-2010 on a stratified multi-stage probability sample of 5940 students aged 10-18 years, living in urban and rural areas of 27 provinces of Iran. Trained healthcare professionals measured anthropometric indices, systolic and diastolic blood pressures (SBP, DBP) according to standard protocols. Fasting venous blood was examined for fasting blood sugar (FBS), lipid profile and liver enzymes including alanine aminotransferase (ALT) and aspartate aminotransferase (AST). We classified the country into four sub-national regions based on criteria of the combination of geography and SES. Mean and frequency of risk factors were compared across these regions. The mean of body mass index had linear rise with increase in the regions' SES ( for trend <0.001). The mean levels of DBP, total cholesterol (TC), high-density lipoproteincholesterol (HDL-C), triglycerides (TG), FBS, ALT, and AST had linear association with regions' SES in the whole population and in both genders ( for trend < 0.05), whereas the corresponding figure was statistically significant for the mean SBP only in girls ( for trend: 0.03) and for the mean of LDL-C in the whole population and in boys ( for trend <0.001). In total and in both genders, there was an escalating trend in the prevalence of elevated FBS, TC and liver enzymes, low HDL-C, and metabolic syndrome by increase in the SES of the region( for trend <0.01). This study proposes that in addition to national health policies on preventing cardiometabolic risk factors, specific interventions should be considered according to the regional SES level.
本研究的目的是探讨生活在不同社会经济地位（SES）地区的伊朗青少年心血管代谢危险因素和肝酶的患病率及均值。据我们所知，这是伊朗首次在国家以下层面报告这些数据的研究。这项多中心研究于2009年至2010年对5940名年龄在10至18岁的学生进行了分层多阶段概率抽样，这些学生生活在伊朗27个省份的城乡地区。训练有素的医疗保健专业人员根据标准方案测量人体测量指标、收缩压和舒张压（SBP、DBP）。对空腹静脉血进行空腹血糖（FBS）、血脂谱和肝酶（包括丙氨酸转氨酶（ALT）和天冬氨酸转氨酶（AST））检测。我们根据地理和SES组合标准将该国分为四个国家以下地区。比较了这些地区危险因素的均值和频率。体重指数均值随地区SES的增加呈线性上升（趋势<0.001）。在整个人口和男女两性中，DBP、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、甘油三酯（TG）、FBS、ALT和AST的平均水平与地区SES呈线性关联（趋势<0.05），而相应数字仅在女孩中SBP均值具有统计学意义（趋势：0.03），在整个人口和男孩中LDL-C均值具有统计学意义（趋势<0.001）。总体而言，在男女两性中，随着地区SES的增加，FBS、TC和肝酶升高、HDL-C降低以及代谢综合征的患病率呈上升趋势（趋势<0.01）。本研究建议，除了国家预防心血管代谢危险因素的卫生政策外，还应根据地区SES水平考虑具体干预措施。
