Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 23, Parvaneh Street, Velenjak, Tehran, Iran.
Department of Biostatistics and Epidemiology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Sci Rep. 2020 Jul 16;10(1):11724. doi: 10.1038/s41598-020-68640-9.
To determine levels of change in risk factors for cardiovascular disease among people with and without a previous diagnosis of diabetes from 2007 to 2016 in Iran. Data were obtained from five rounds of the World Health Organization STEPwise approach to Surveillance (STEPS) cross-sectional surveys. Participants were 7665 and 93,733 adults with and without known diabetes, respectively, aged 25-65 years. We used logistic and linear regressions to assess the trends of risk factors. Individuals with known diabetes compared to those without the condition, experienced greater reductions in mean levels of systolic blood pressure (3.0 vs. 0.5 mmHg among women and 3.9 vs. 1.6 mmHg among men), diastolic blood pressure (6.4 vs. 5.11 mmHg in women and 3.3 vs. 1.8 mmHg in men), and non-HDL cholesterol (42.4 vs. 27.2 mg/dL among women and 30.3 vs. 21.0 mg/dL among men) throughout these years. Men with diabetes also showed a greater reduction in the prevalence of daily cigarette smoking compared to their non-diabetic counterparts (7.3% vs. 2.3%). Fasting plasma glucose decreased among subjects with diabetes but increased among those without diabetes. Significant increases were observed in proportions who met goals for blood pressure, triglycerides, non-HDL cholesterol and LDL cholesterol in both groups; however, almost half of diabetic subjects did not achieve risk factor goals in 2016. Secondary prevention in diabetic patients was more effective than primary prevention in the general population; however, the rate of diabetic patients who met the designated goals for each risk factor was still suboptimal.
从 2007 年至 2016 年，在伊朗，比较有或无既往糖尿病诊断的人群中，心血管疾病危险因素变化水平。数据来自世界卫生组织 STEP 式监测（STEPS）的五轮横断面调查。参与者分别为 7665 名和 93733 名有或无已知糖尿病的成年人，年龄 25-65 岁。我们使用逻辑和线性回归来评估危险因素的趋势。与无糖尿病者相比，有糖尿病者收缩压（女性 3.0 对 0.5mmHg，男性 3.9 对 1.6mmHg）、舒张压（女性 6.4 对 5.11mmHg，男性 3.3 对 1.8mmHg）和非高密度脂蛋白胆固醇（女性 42.4 对 27.2mg/dL，男性 30.3 对 21.0mg/dL）的平均水平均有更大幅度的降低。糖尿病男性与非糖尿病男性相比，每日吸烟的比例也有更大幅度的降低（7.3%对 2.3%）。糖尿病患者的空腹血糖降低，但无糖尿病患者的空腹血糖升高。两组人群中，达到血压、甘油三酯、非高密度脂蛋白胆固醇和低密度脂蛋白胆固醇目标的比例均显著增加；然而，2016 年仍有近一半的糖尿病患者未达到危险因素目标。与普通人群的一级预防相比，糖尿病患者的二级预防更有效；然而，达到每个危险因素指定目标的糖尿病患者比例仍不理想。
