Papers by Hamidreza Roohafza
Association of Cigarette Smoking with Depression and Anxiety in Middle-Aged Adults: a Large Cross-Sectional Study among Iranian Industrial Manufacturing Employees
International Journal of Mental Health and Addiction, Oct 25, 2021
This study aimed to examine the association of cigarette smoking with depression and anxiety in a... more This study aimed to examine the association of cigarette smoking with depression and anxiety in a large sample of formal and contractual employees of a mill steel company, Isfahan, Iran. This cross-sectional study was performed in 2014 among 3063 formal and contractual employees. Multi-stage cluster sampling along with stratified sampling based on managerial sections were employed for participants’ selection. Data gathering was done by some validated Iranian version of self-administered questionnaires including, International Physical Activity – Short Form, Effort–Reward Imbalance, Hospital Anxiety and Depression Scale. The results showed in crude and adjusted models, smokers compared with never smoked had a higher risk of depression (crude OR: 1.45; 95% CI: 1.01–2.07 and adjusted OR: 1.52; 95% CI: 1.04, 2.23). Smoking was significantly associated with anxiety both in crude and adjusted models (OR: 1.66; 95% CI: 1.24, 2.23) and (OR: 1.74; 95% CI: 1.27, 2.38), respectively. Our study showed that the depression and anxiety were more prevalent in smoker workforce population than non-smokers. In order to reduce the current and future psychological disorders’ burden among workforce population, it is needed to conduct mental health promotion and interventions such as effective smoking cessation programs.
Research Square (Research Square), Jul 6, 2020
Background and objectives: Quality of Life (QoL) indicates individual's perception of the physica... more Background and objectives: Quality of Life (QoL) indicates individual's perception of the physical, psychological and social aspects of health. The association between QoL and all stressful life events 'dimensions has not been investigated among industrial employees. The present study aimed at investigating the association between stressful life events and QoL in a large sample of Iranian industrial employees. Methods: In a cross-sectional study, 3063 manufacturing employees in Isfahan, Iran were recruited. QoL was measured by Euro-QoL ve dimensions questionnaire (EQ-5D). Stressful life events were assessed by an Iranian validated stressful life event questionnaire (SLE). Multilevel latent class regression was employed for classifying participants based on QoL and for determining its association with stressful life events. Results: Two classes of employees i.e. low (comprised 20% of participants) and high QoL (80%) were identi ed. Also, from 11 eleven dimensions of stressful life events two major domains i.e. socioeconomic and personal stressor pro les were identi ed. Multilevel latent class regression's results showed that the higher scores of social (OR:1.14, 95% CI: 1.12, 1.16) and personal (OR:2.36, 95% CI: 1.87, 2.98) stressor domains were signi cantly associated with increased risk of being in poor QoL class. Among personal and socioeconomic stressors, health concerns and daily life dimensions had higher signi cant association with poor QoL. Conclusions: Results of our study indicated that life stressors have negative impacts on QoL of employees. Personal stressors showed higher negative impacts than socioeconomic on QoL. Managing the stressors has an effective role on improving the QoL of employees, their physical and mental health and indirectly enhances the organizational performance and job productivity.
Psychometric Properties of the Persian Version of Screening for Somatic Symptom Disorders-7(SOMS-7)
PubMed, Oct 1, 2018
Objective: Somatic symptoms are one of the most prevalent complaints in both psychiatric and gene... more Objective: Somatic symptoms are one of the most prevalent complaints in both psychiatric and general population, and validated scales are required to assess these problems. The present study was conducted to determine psychometric properties of the Persian version of Screening for Somatic Symptom Disorders-7(SOMS-7) in an Iranian population. Method : This was a multi centric comprehensive study conducted in Psychosomatic Research Center of Isfahan University of Medical Sciences in collaboration with Department of Clinical Psychology of Philipp University of Marburg, Germany. This part of the study includes 100 patients with anxiety/mood disorders and 291 healthy individuals. All participants completed the Patient Health Questionnaire (PHQ-15) and Screening for Somatic symptom disorders 7(SOMS-7). Data were analyzed by Pearson and Spearman correlation coefficient, factor analysis, independent t test, and discriminant analysis using SPSS-20 software. Results: Reliability coefficient based on Cronbach's alpha was 0.92 and 0.94 (clinical vs. healthy sample). Validity index of the SOMS according to correlation between factor 1 and 2 with PHQ somatic subscale was. 51 and. 59, respectively. Score of 15.5 as cut-off point was accompanied with sensitivity of 77% and specificity of 66%. Factor analysis extracted 2 factors in patients and 4 factors in healthy population. Conclusion: Findings of this study indicated that the Persian version of SOMS-7 has appropriate reliability and validity for the assessment of somatic symptoms disorder and evaluation of treatment effects in these patients.
The association between mental health and quality of life: A cross-sectional study in a large sample of Isfahan Steal Company's employees
PubMed, Jan 22, 2019
Background: Selenium is the component of selenocystein amino acid, which itself is the building b... more Background: Selenium is the component of selenocystein amino acid, which itself is the building block of selenoproteins having diverse effects on various aspects of the human health. Among these proteins, selenoprotein P is the central to the distribution and homeostasis of selenium, and selenoprotein S as a transmembrane protein is associated with a range of inflammatory markers, particularly in the context of cardiovascular disease. It is known that selenium status outside of the normal range is considered to confer different benefits or adverse cardiovascular risk factors. Therefore, for the first time, we aimed to verify effects of Selenium supplementation on Selenoprotein P and S Genes Expression in Protein and mRNA Levels in Subjects with Coronary Artery Disease (CAD). Methods: This is the study protocol of a double blinded randomized clinical trial on 130 subjects with angiographically documented stenosis of more than 75% in one or more coronary artery vessels. In this 60-day study, 65 patients in each group received either a 200mg selenium yeast or placebo tablets once daily. During the study, subjects were followed by phone calls and visited our clinic twice to repeat baseline measurements. We hypothesized that our finding would enable a more basic and confirmed understanding for the effect of selenium supplementation by investigating its effect on gene expression levels in people with CAD. Discussion: Upon confirmation of this hypothesis, the beneficial effect of inflammation regulation by supplementation with micronutrients could be considered for subjects with CVD.
Risk Management and Healthcare Policy, Aug 1, 2020
Background: Quality of life (QoL) indicates individual's perception of the physical, psychologica... more Background: Quality of life (QoL) indicates individual's perception of the physical, psychological and social aspects of health. The association between QoL and all stressful life events' dimensions has not been investigated among industrial employees. Purpose: The present study aimed to investigate the association between stressful life events and QoL in a large sample of Iranian industrial employees. Material and Methods: In a cross-sectional study, 3063 manufacturing employees in Isfahan, Iran, were recruited. QoL was measured with the Euro-QoL five dimension questionnaire (EQ-5D). Stressful life events were assessed by an Iranian validated stressful life event questionnaire (SLE). Multilevel latent class regression was employed for classifying participants based on QoL and for determining its association with stressful life events. Results: Two classes of employees, ie, low (comprised 20% of participants) and high QoL (80%), were identified. From 11 dimensions of stressful life events two major domains, socioeconomic and personal stressor profiles, were identified. Multilevel latent class regression results showed that the higher scores of social (OR: 1.14, 95%CI: 1.12-1.16) and personal (OR: 2.36, 95%CI: 1.87-2.98) stressor domains were significantly associated with increased risk of being in the poor QoL class. Among personal and socioeconomic stressors, health concerns and daily life dimensions had higher significant association with poor QoL. Conclusion: Results of our study indicated that life stressors have negative impacts on QoL of employees. Personal stressors showed higher negative impact than socioeconomic on QoL. Managing the stressors can play an effective role in improving the QoL of employees, their physical and mental health, and indirectly enhances the organizational performance and job productivity.
Do coping strategies really affect cardiovascular events? The Isfahan cohort study of adults in Eastern Mediterranean Regional Office
European Journal of Cardiovascular Nursing, Nov 25, 2021
Aims Psychological factors are among the most suspected indicators which may cause atherosclerosi... more Aims Psychological factors are among the most suspected indicators which may cause atherosclerosis. Coping strategies modifying psychological stress may be significantly associated with health outcomes. However, little is known about the influence of adaptive and maladaptive coping strategies on major adverse cardiovascular disease (CVD) events. The purpose of this study is to examine this idea among a sample of adults. Design: cohort study. Methods and results The Isfahan cohort study (ICS) is a longitudinal population-based, prospective study. Participants (N=6323 individuals aged 35 years or greater at baseline) were selected by multistage random sampling with 6-year intervals (i.e. 2001: 6323 individuals, 2007: 3296 individuals, and 2013: 1706 individuals). Adaptive and maladaptive coping strategies were evaluated by a multicomponent self-administered stress management paper-based questionnaire. All CVD events were confirmed by a blinded panel of experts and a marginal cox regression model was used to model the survival data. Adaptive coping strategies could be protective against CVD events with hazard ratios (95% confidence interval) [0.97 (0.95–0.99)] and maladaptive coping strategies seem to be a risk factor, 1.02 (1.01–1.04) in the whole population. Individuals younger than 60 showed similar results, with 0.96 (0.93–0.98) and 1.04 (1.01–1.07) for adaptive and maladaptive coping strategies, respectively. However, these findings were not replicated among seniors older than age 60. Conclusion Based on our results, coping strategies have an important role in cardiovascular events, particularly among young adults. According to the results, informing patients about adaptive stress management may promote primary prevention of CVD events.
Investigating the relationship between job stress and obesity in employees of Isfahan Steel Company based on a cross-sectional study
Iran Occupational Health, May 10, 2020
12-year follow-up study of the c-reactive protein in Iranian middle-aged women: Isfahan cohort study
Advances in human biology, 2019
Background: As an important inflammatory marker, study of C-reactive protein (CRP) changes over t... more Background: As an important inflammatory marker, study of C-reactive protein (CRP) changes over time may lead to better identification of risk factors of cardiovascular disease. We evaluated the relationship between CRP changes and lifestyle, metabolic syndrome (MS) and body mass index (BMI) in middle-aged women and explored potential bias from attrition. Materials and Methods: We studied 1234 participants in the Isfahan cohort study – a longitudinal population-based study of adults older than 35 years living in urban and rural areas of three counties in central Iran. Data were collected every 6 years since 2001 (3 points). Random effects model was used to evaluate the effects of behavioural risk factors and MS on CRP, with pattern mixture model to account for cohort attrition. Results: Mean CRP levels decreased over time (Est = −0.066, P < 0.001). MS (Est = −0.195, P < 0.001), BMI (Est = 0.022, P < 0.001), physical activity (Est = −0.009, P = 0.002) and history of smoking (Est = −0.399, P = 0.002) were independently associated with increases in CRP. Pattern mixture model showed that CRP decreased in participants with monotone measurement (Est = −0.032, P < 0.001), as well as intermittent measurement (Est = −0.022, P < 0.001), with no association in participants who responded at all points (Est = −0.015, P = 0.083). Conclusion: In this study, the rate of changes in CRP level in middle-aged women over time was higher in participants who were irregularly measured than those who measured continuously. MS, BMI and physical activity may be related to the CRP changes over time in middle-aged women.
Iranian Red Crescent Medical Journal, Jun 24, 2019
Background: Trends of major cardiovascular risk factors are less investigated in Middle-Eastern c... more Background: Trends of major cardiovascular risk factors are less investigated in Middle-Eastern countries. Objectives: This study aimed to assess the trend of major cardiovascular risk factors among Iranian individuals. Methods: This Longitudinal population-based study was performed by multistage random sampling on 6504 participants aged at least 35 years for 12 years initiating in 2001 until 2013 in three phases. Cardiovascular risk factors including systolic blood pressure (SBP), diastolic blood pressure (DBP), waist circumference (WC), waist to hip ratio (WHR), body mass index (BMI), fasting blood sugar (FBS) and lipid indices were measured for each subject in 2001, 2007 and 2013 and were analyzed using repeated measure analysis of variance using Bonferroni correction. Results: Mean value of SBP, DBP, BMI and FBS increased significantly in both genders during follow-up (SBP: 119.3 ± 18.7 to 128.4 ± 17.5 mmHg, P value < 0.001, DBP: 76.7 ± 11.8 to 82.8 ± 12.5 mmHg, P value < 0.001, BMI: 27.4 ± 4.4 to 28 ± 4.6 kg/m 2 , P value < 0.001, FBS: 86.7 ± 29.6 to 106.5 ± 38 mg/dL, P value < 0.001). Lipid profiles including total cholesterol (TC), triglyceride (TG), lowdensity lipoprotein cholesterol (LDL-C) and TG/ high-density lipoprotein cholesterol (HDL-C) showed favorable downward patterns in population (TC: 219.5 ± 51.3 to 200.1 ± 40.9 mg/dL, P value < 0.001, TG: 200.2 ± 110.3 to 155.1 ± 85 mg/dL, P value < 0.001, LDL-C: 132.6 ± 42.4 to 111.7 ± 27.8 mg/dL, P value < 0.001, TG/HDL-C: 4.5 ± 2.8 to 3.9 ± 2.8, P value < 0.001) with an exception of HDL-C showing less desirable results. In spite of controversial results in terms of WC and WHR changes relative to gender, total population changes of those variables were not significant. Conclusions: Although favorable patterns were observed in most lipid indices, other risk factors showed an inverse or insignificant trend. Several health-promoting strategies are required in order to improve lifestyle in a way that those raising cardiovascular risk factor trends would decline.
Stress and Heart
ARYA atherosclerosis, Dec 8, 2010
... Email: [email protected] Page 2. H Roohafza ARYA Journal 2006 (spring); Volume 2, Issue ... more ... Email: [email protected] Page 2. H Roohafza ARYA Journal 2006 (spring); Volume 2, Issue 1 61 ... 14. Roohafza HR, Salehi B, Sadeghi M. Prevalence and severity of stress in Isfahan and arak province 1381 (2002). Rahavard Danesh journal, 2007 (in press).
PubMed, Nov 1, 2018
Background: Previous studies revealed that the level of 25-hydroxyvitamin D [25(OH)D] could be co... more Background: Previous studies revealed that the level of 25-hydroxyvitamin D [25(OH)D] could be consider as one the risk factors for the occurrence of cardiovascular diseases (CVDs). This study aimed to evaluate the relationship between serum 25(OH)D level and CVD events in individuals with and without metabolic syndrome (MetS) in an Iranian population. Methods: In this nested case-control study conducted as a part of the Isfahan Cohort Study (ISC), 55 patients with CVD events were selected as case group, and 55 sex- and age-matched individuals without CVD events as control group. These participants were divided into the two main groups based on the presence of MetS at baseline. Results: The level of 25(OH)D in individuals with and without MetS was significantly lower among patients with CVD compared to those without CVD events at the baseline of study and after the follow-up (P = 0.036 and P = 0.039, respectively). The level of 25(OH)D significantly decreased risk of incidence of CVD events in individuals without MetS after adjusting for age, sex, nutrition, and exposure to sunlight [0.19 (0.05-0.73); P = 0.016]. There was not any significant relationship between the amount of 25(OH)D at the baseline and CVD events in individuals with MetS. Conclusion: In individuals with MetS, the level of 25(OH)D is not related to CVD events; as MetS directly influence the pathophysiology of mechanisms which are responsible for CVD events, and maybe this effect obscure the effect of 25(OH)D.
Acta Cardiologica, Feb 5, 2020
Background: Dyslipidaemia is a risk factor for cardiovascular disease (CVD); however, there are o... more Background: Dyslipidaemia is a risk factor for cardiovascular disease (CVD); however, there are only a few long-term cohort studies. The aim of this unique study is to evaluate the effects of several lipid markers on cardiovascular outcomes during a 15-year follow-up from the Isfahan cohort study (ICS). Methods: This ongoing cohort study was started in 2001 in three cities of Iran. The study population includes 5432 individuals older than 35 years and with Iranian citizenship. All of the patients were evaluated every 2 years by telephone and a full medical examination with blood sampling was conducted every 5 years. The data were recorded in our checklists. Dyslipidaemia was defined according to the ATPIII criteria. Our endpoints in this study were any cardiovascular events such as stroke, sudden cardiac death, unstable angina or myocardial infarction (MI). Results: cardiovascular events were significantly higher in males, older people, diabetics, smokers, patients with higher BMIs, higher blood pressure, dyslipidaemia and less educational level, physical activity index and global dietary index. Our adjusted multivariable analysis (for cardiovascular risk factors and demographic factors) revealed that dyslipidaemia could increase the risk of 15-year cardiovascular events by 1.59 times (HR ¼ 1.59 [1.23-2.06], p value < .001) adjusted for demographic factors and baseline cardiovascular risk factors. Conclusions: Dyslipidaemia, as an independent risk factor, was associated with future cardiovascular events. In this regard, serum lipid screening can help to decrease the risk of long-term cardiovascular events.
PubMed, 2012
Background: This study was designed to assess the effectiveness of stress management training in ... more Background: This study was designed to assess the effectiveness of stress management training in improving the ability of coping with stress in a large population. Methods: Five cross-sectional studies using multistage cluster random sampling were performed on adults aged ≥ 19 years between 2000 to 2005 in Isfahan and Najafabad (Iran) as intervention cities and Arak, Iran as the control city within the context of Isfahan Healthy Heart Program. Stress management training was adapted according to age and education levels of the target groups. In a 45-minute home interview, demographic data, General Health Questionnaire (GHQ) and stress management questionnaires were collected. Data was analyzed by t-test, linear regression and general linear model. Results: Trends of both adaptive and maladaptive coping skills and GHQ scores from baseline to the last survey were statistically significant in both intervention and reference areas (P < 0.001). While adaptive coping skills increased significantly, maladaptive coping skills decreased significantly in the intervention areas. Furthermore, stress levels decreased significantly in the intervention compared to the reference area. Conclusion: Stress management programs could improve coping strategies at the community level and can be considered in designing behavioral interventions.
The predictive value of atherogenic index of plasma in the prediction of cardiovascular events; a fifteen-year cohort study
Advances in Medical Sciences, Sep 1, 2021
PURPOSE Cardiovascular events (CVE) are the most prominent cause of death worldwide. Therefore, a... more PURPOSE Cardiovascular events (CVE) are the most prominent cause of death worldwide. Therefore, achieving a precise affordable index for the prediction of healthy cases at increased risk of CVE in early stages and subsequently lessening the rate of CVE mortality is a critical goal of healthcare systems. We aimed to assess the value of Atherogenic index of plasma (AIP) in the prediction of CVE and mortality through a 15-year cohort study. MATERIALS/METHODS This study was conducted on 6323 over 35-year-old healthy adults from 2001 to 2016. The baseline AIP was measured based on the formula of TG to HDL logarithm and divided into three subgroups of low, intermediate, and high risk of CVD, as <0.11, 0.11-0.21, and ≥0.21, respectively. Eventually, the association of AIP with sociodemographic, lifestyle, traditional CVE-related factors and CVE-induced mortality was evaluated. RESULTS The multiple cox regression study of AIP values for the prediction of CVE incidence revealed a significant association (OR: 1.57, 95%CI: 1.33-1.85); similar remarkable associations were achieved by controlling age and sex (OR: 1.55, 95%CI: 1.31-1.83), sociodemographic factors (OR: 1.51, 95%CI: 1.29-1.79), sociodemographic plus lifestyle factors (OR: 1.54, 95%CI: 1.30-1.81) and sociodemographic, lifestyle and the traditional CVE-related factors (OR: 1.28, 95%CI: 1.07-1.54). The Kaplan-Meier survival study showed a significant association between AIP levels and CVE-related mortality (p <0.001). CONCLUSION In conclusion, AIP is an independent stand-alone factor for the prediction of developing CVE and its-related mortality.
Global heart, Feb 6, 2020
Background: High sensitivity C-reactive protein (hs-CRP) was proven to be an independent risk fac... more Background: High sensitivity C-reactive protein (hs-CRP) was proven to be an independent risk factor for cardiovascular diseases (CVDs). The aim of this study was to investigate the benefits of assessing hs-CRP among individuals with different cardiovascular risk factors. Methods: This nested case-control study was obtained from the Isfahan Cohort Study (ICS). Anyone who has been suffering from any CVDs, including myocardial infarction, unstable angina, sudden cardiac death and stroke was put in the case group. Density sampling method was utilized to choose the control group who had no aforementioned CVDs during follow-up. Four quartiles of hs-CRP (Q1: 0.1-2.3, Q2: 2.4-3, Q3: 3.1-4 and Q4: 4.1-14 mg/l) were assessed defining odds ratios (OR) of CVDs prediction in different CVDs risk factor categories. Confidence intervals of 95% are put in brackets. Results: A total of 502 cases and 538 controls were recruited. All hs-CRP quartiles showed increased CVDs likelihood compared to normal subjects in terms of diabetes mellitus (DM) and hypertension (HTN). Second quartile showed a 1. 93 [1.33-2.81] and 3.34 [1.36-8.17] increased risks in patients with hypertriglyceridemia or dyslipidemia, respectively. Smokers in the third quartile group revealed increased CVDs risk. The fourth quartile showed significant increased risks in patients suffering from hypercholesterolemia ), high LDL-C (OR = 1.88 [1.33-2.66]), and hypertriglyceridemia ). Conclusions: Our findings suggested that assessing hs-CRP is beneficial for predicting CVDs in patients with HTN and DM. Furthermore, specific patients with lipid abnormalities or history of smoking benefits from checking hs-CRP.
The Impacts of Cardiac Rehabilitation Program on Exercise Capacity, Quality of Life, and Functional Status of Coronary Artery Disease Patients with Left Ventricular Dysfunction
Rehabilitation Nursing, Sep 1, 2015
To determine the impacts of cardiac rehabilitation on exercise capacity, quality of life (QOL), a... more To determine the impacts of cardiac rehabilitation on exercise capacity, quality of life (QOL), and functional status in patients with coronary artery disease (CAD). Self-controlled clinical trial. CAD patients with mild to moderate left ventricular dysfunction participated in an exercise-based rehabilitation program for eight consecutive weeks. Subjects underwent an exercise test before and 8 weeks after rehabilitation. QOL was assessed with the SF-36 questionnaire. Functional status was assessed in terms of sleep time, walking, cycling, exercise, and working duration. Seventy patients (age = 57.5 ± 10.2 years, 77.1% male) were studied. After rehabilitation, peak exercise capacity increased from 8.00 ± 2.56 to 10.08 ± 3.00 METs (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001) and exercise duration increased from 14.17 ± 5.27 to 17.21 ± 5.85 minutes (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). Patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; QOL improved in physical and psychological dimensions (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Cycling, walking, and exercising status significantly increased after the study (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Cardiac rehabilitation improves exercise capacity, QOL, and functional status of CAD patients with mild to moderate left ventricular dysfunction. Cardiac rehabilitation practitioners should encourage patients to attend to and be compliant in the rehabilitation programs.
The association between daytime sleep and general obesity risk differs by sleep duration in Iranian adults
Annals of Human Biology, Jan 2, 2023
Scientific Reports
To investigate the longitudinal association of different phenotypes of diabetes and obesity with ... more To investigate the longitudinal association of different phenotypes of diabetes and obesity with the incidence of cardiovascular disease (CVD), CVD- and all-cause mortality. A total of 5432 adults, aged ≥ 35 years and free of CVD were included in this cohort study. Diabesity phenotypes were defined in six categories based on the presence of diabetes (normal (NG), prediabetes and diabetes) and obesity (obese, non-obese). Fasting blood sugar, 2-h post prandial glucose, or using anti-diabetic medicines were used to define diabetes, and body mass index and waist circumference were used to define obesity. Cox proportional hazards models were used to estimate hazard ratios (HRs) for incident CVD, CVD- and all-cause mortality across these categories. After a median follow-up of 11.25 years, 819 CVD cases, 181 CVD deaths and 488 all-cause deaths occurred. In multivariable-adjusted models and irrespective of obesity definition, the phenotypes of normal glucose-obese, prediabetes-obese and pr...
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Papers by Hamidreza Roohafza