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Original Articles
Associations between dietary risk factors and ischemic stroke: a comparison of regression methods using data from the Multi-Ethnic Study of Atherosclerosis
Seyed Saeed Hashemi Nazari, Yaser Mokhayeri, Mohammad Ali Mansournia, Soheila Khodakarim, Hamid Soori
Epidemiol Health. 2018;40:e2018021.   Published online May 21, 2018
DOI: https://doi.org/10.4178/epih.e2018021
  • 15,378 View
  • 267 Download
  • 13 Web of Science
  • 9 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
We analyzed dietary patterns using reduced rank regression (RRR), and assessed how well the scores extracted by RRR predicted stroke in comparison to the scores produced by partial least squares and principal component regression models.
METHODS
Dietary data at baseline were used to extract dietary patterns using the 3 methods, along with 4 response variables: body mass index, fibrinogen, interleukin-6, and low-density lipoprotein cholesterol. The analyses were based on 5,468 males and females aged 45-84 years who had no clinical cardiovascular disease, using data from the Multi-Ethnic Study of Atherosclerosis.
RESULTS
The primary factor derived by RRR was positively associated with stroke incidence in both models. The first model was adjusted for sex and race and the second model was adjusted for the variables in model 1 as well as smoking, physical activity, family and sibling history of stroke, the use of any lipid-lowering medication, the use of any anti-hypertensive medication, hypertension, and history of myocardial infarction (model 1: hazard ratio [HR], 7.49; 95% confidence interval [CI], 1.66 to 33.69; p for trend=0.01; model 2: HR, 6.83; 95% CI, 1.51 to 30.87 for quintile 5 compared with the reference category; p for trend=0.02).
CONCLUSIONS
Based primarily on RRR, we identified that a dietary pattern high in fats and oils, poultry, non-diet soda, processed meat, tomatoes, legumes, chicken, tuna and egg salad, and fried potatoes and low in dark-yellow and cruciferous vegetables may increase the incidence of ischemic stroke.
Summary

Citations

Citations to this article as recorded by  
  • Trimethylamine N-oxide, β-alanine, tryptophan index, and vitamin B6-related dietary patterns in association with stroke risk
    Dong Liu, Siyue Tan, Zhengyuan Zhou, Shujun Gu, Hui Zuo
    Nutrition, Metabolism and Cardiovascular Diseases.2024; 34(5): 1179.     CrossRef
  • A comparison of principal component analysis, reduced-rank regression, and partial least–squares in the identification of dietary patterns associated with cardiometabolic risk factors in Iranian overweight and obese women
    Fatemeh Gholami, Ahmadreza Hajiheidari, Bahareh Barkhidarian, Neda Soveid, Mir Saeid Yekaninejad, Zahra Karimi, Niki Bahrampour, Seyed Ali Keshavarz, Gholamali Javdan, Khadijeh Mirzaei
    BMC Medical Research Methodology.2024;[Epub]     CrossRef
  • Comparison of data-driven identified hypertension-protective dietary patterns among Chinese adults: based on a nationwide study
    Yuxiang Yang, Wei Piao, Shuya Cai, Kun Huang, Changzheng Yuan, Xue Cheng, Ling Zhang, Yuge Li, Liyun Zhao, Dongmei Yu
    European Journal of Nutrition.2023; 62(7): 2805.     CrossRef
  • Associations between dietary patterns and cardiovascular disease risk in Canadian adults: a comparison of partial least squares, reduced rank regression, and the simplified dietary pattern technique
    Svilena V Lazarova, Mahsa Jessri
    The American Journal of Clinical Nutrition.2022; 116(2): 362.     CrossRef
  • Association Between Dietary Quality Indices and Atherosclerosis Risk: A Case-Control Study
    Mahsa Samadani, Anahita Mansoori, Habib Haybar, Fatemeh Haidari, Majid Mohammadshahi
    Nutrition and Metabolic Insights.2022;[Epub]     CrossRef
  • Visceral adiposity-related dietary patterns and the risk of cardiovascular disease in Iranian adults: A population-based cohort study
    Nazanin Moslehi, Fatemeh Rahimi Sakak, Maryam Mahdavi, Parvin Mirmiran, Fereidoun Azizi
    Frontiers in Nutrition.2022;[Epub]     CrossRef
  • Dietary patterns derived by reduced rank regression and non-communicable disease risk
    Carmen Piernas, Min Gao, Susan A. Jebb
    Proceedings of the Nutrition Society.2022; : 1.     CrossRef
  • Dietary patterns related to cardiovascular disease based on reduced rank regression analysis of healthy middle-aged Koreans: data from the community-based Korean Genome and Epidemiology Study (KoGES) cohort
    Hye Ah Lee, Hyoin An, EunJin Lee
    The American Journal of Clinical Nutrition.2020; 111(6): 1159.     CrossRef
  • Interaction between an ATP-Binding Cassette A1 (ABCA1) Variant and Egg Consumption for the Risk of Ischemic Stroke and Carotid Atherosclerosis: a Family-Based Study in the Chinese Population
    Jing Song, Xia Jiang, Yaying Cao, Juan Juan, Tao Wu, Yonghua Hu
    Journal of Atherosclerosis and Thrombosis.2019; 26(9): 835.     CrossRef
The effects of water-pipe smoking on birth weight: a population-based prospective cohort study in southern Iran
Shahrzad Nematollahi, Mohammad Ali Mansournia, Abbas Rahimi Foroushani, Mahmood Mahmoodi, Azin Alavi, Mohammad Shekari, Kourosh Holakouie-Naieni
Epidemiol Health. 2018;40:e2018008.   Published online March 13, 2018
DOI: https://doi.org/10.4178/epih.e2018008
  • 13,896 View
  • 228 Download
  • 21 Web of Science
  • 20 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Consecutive community health assessments revealed that water-pipe smoking in women and impaired growth in children were among the main health concerns in suburban communities in southern Iran. The aim of the present study was to identify the effects of water-pipe smoking during pregnancy on birth weight.
METHODS
Data from a population-based prospective cohort study of 714 singleton live pregnancies in the suburbs of Bandar Abbas in southern Iran in 2016-2018 were used in this study. Data about water-pipe smoking patterns and birth weight were collected by questionnaires during and after the pregnancy. Low birth weight (LBW) was defined as a birth weight below 2,500 g. Statistical analyses were performed using generalized linear models, and the results were presented in terms of relative risk (RR) and 95% confidence intervals (CI).
RESULTS
Fifty (8.2%) of the study subjects smoked water-pipe. The adjusted risk of LBW increased 2-fold in water-pipe smokers (adjusted RR [aRR], 2.09; 95% CI, 1.18 to 3.71), and by 2.0% for each 1-year increase in the duration of water-pipe smoking (aRR, 1.02; 95% CI, 0.99 to 1.05).
CONCLUSIONS
Our results showed that water-pipe smoking during pregnancy was an important risk factor for LBW in this population sample from southern Iran. The introduction of regulations onto prevent water-pipe smoking and the implementation of community health action plans aiming at empowering women and increasing women’s knowledge and awareness regarding the health consequences of water-pipe smoking are proposed.
Summary

Citations

Citations to this article as recorded by  
  • The Diversity in Tobacco Use Among Women of Reproductive Age (15–49 Years) in Pakistan: A Secondary Analysis of a Multiple Indicator Cluster Survey 2016–2018
    Radha Sharma, Mona Kanaan, Kamran Siddiqi
    Nicotine and Tobacco Research.2024; 26(7): 931.     CrossRef
  • Sevrage tabagique au cours de la grossesse
    V. Peyronnet, A.-L. Le Faou, I. Berlin
    Revue des Maladies Respiratoires.2024; 41(9): 685.     CrossRef
  • Waterpipe Tobacco (Hookah) Use in Pregnancy: Associations with Nausea and Vomiting of Pregnancy
    Anna R. Whelan, Alexis C. Gimovsky, Nancy C. Jao, Erika F. Werner, Chrystal Vergara-Lopez, Laura R. Stroud
    American Journal of Perinatology.2023; 40(10): 1033.     CrossRef
  • Interventions for waterpipe smoking cessation
    Taghrid Asfar, Jonathan Livingstone-Banks, Kenneth D Ward, Thomas Eissenberg, Olusanya Oluwole, Zoran Bursac, Tarek Ghaddar, Wasim Maziak
    Cochrane Database of Systematic Reviews.2023;[Epub]     CrossRef
  • Dual and Poly Use of Tobacco Products in a Sample of Pregnant Smokers: A Cross-sectional Study
    André Luís Bertani, Suzana Erico Tanni, Irma Godoy
    Maternal and Child Health Journal.2023; 27(9): 1616.     CrossRef
  • Reproductive outcomes of water pipe smoking: A scoping review
    Sahar Rostami, Farzane Fereidouni, Arezoo Maleki-Hajiagha, Mohadese Motaharinejad, Somayye Majidi, Fardin Amidi
    Asian Pacific Journal of Reproduction.2023; 12(5): 211.     CrossRef
  • What are the intervention goals of women’s hookah cessation? A systematic, evidence-based and participatory study
    Sakineh Dadipoor, Teamur Aghamolaei, Mehdi Mirzaei-Alavijeh, Mohtasham Ghaffari, Ali Heyrani, Saeed Hosseini Teshnizi
    Journal of Ethnicity in Substance Abuse.2022; 21(4): 1468.     CrossRef
  • Maternal smoking status during pregnancy and low birth weight in offspring: systematic review and meta-analysis of 55 cohort studies published from 1986 to 2020
    Hong-Kun Di, Yong Gan, Kai Lu, Chao Wang, Yi Zhu, Xin Meng, Wen-Qi Xia, Min-Zhi Xu, Jing Feng, Qing-Feng Tian, Yan He, Zhi-Qiang Nie, Jun-An Liu, Fu-Jian Song, Zu-Xun Lu
    World Journal of Pediatrics.2022; 18(3): 176.     CrossRef
  • Using intervention mapping for hookah smoking cessation: a quasi-experimental evaluation
    Sakineh Dadipoor, Ali Heyrani, Mehdi Mirzaei-Alavijeh, Teamur Aghamolaei, Mohtasham Ghaffari, Amin Ghanbarnejad
    Addiction Science & Clinical Practice.2022;[Epub]     CrossRef
  • Association Between a History of Hookah Use and Breastfeeding Duration
    Zelalem T. Haile, Ilana R. Azulay Chertok, Mohammad Rifat Haider
    Breastfeeding Medicine.2022; 17(8): 678.     CrossRef
  • Waterpipe Tobacco Smoke Exposure during Lactation—Susceptibility of Reproductive Hormones and Oxidative Stress Parameters in Male Progeny Rats
    Nour A. Al-Sawalha, Indira D. Pokkunuri, Karem H. Alzoubi, Omar F. Khabour, Bashar N. Almomani
    Reproductive Sciences.2021; 28(1): 37.     CrossRef
  • Trends of maternal waterpipe, cigarettes, and dual tobacco smoking in Jordan. A decade of lost opportunities
    Khalid A. Kheirallah, Nuha Shugaa Addin, Maan M. Alolimat, Eman Sobh
    PLOS ONE.2021; 16(7): e0253655.     CrossRef
  • Effect of Water-Pipe Smoking on the Normal Development of Zebrafish
    Zain Zaki Zakaria, Shaima Ahmad Aladwi, Fatiha Benslimane, Enas S. Al-Absi, Mashael Al-Shafai, Huseyin C. Yalcin, Ashraf Khalil, Ala-Eddin Al Moustafa, Maha Al-Asmakh
    International Journal of Environmental Research and Public Health.2021; 18(21): 11659.     CrossRef
  • An intervention development for cessation of hookah smoking among Iranian women: study protocol for a systematic and theory-based approach to intervention design
    Sakineh Dadipoor, Gerjo Kok, Ali Heyrani, Teamur Aghamolaei, Mohtasham Ghaffari, Amin Ghanbarnezhad
    Addiction Science & Clinical Practice.2020;[Epub]     CrossRef
  • The effect of quitting water pipe during pregnancy on anthropometric measurements at birth: a population-based prospective cohort study in the south of Iran
    Shahrzad Nematollahi, Koroush Holakouie-Naieni, Abdolhossain Madani, Hossein Shabkhiz, Elham Torabi, Samane Lotfi
    BMC Pregnancy and Childbirth.2020;[Epub]     CrossRef
  • Autres méthodes de consommation pendant la grossesse : cigarette électronique, tabac chauffé, chicha et snus — Rapport d’experts et recommandations CNGOF-SFT sur la prise en charge du tabagisme en cours de grossesse
    C. Garabedian, P. Berveiller, P. Guerby
    Gynécologie Obstétrique Fertilité & Sénologie .2020; 48(7-8): 583.     CrossRef
  • Predictors of Hookah Smoking among Women in Bandar Abbas, Southern Iran: A Cross-Sectional Study Based on the Intervention Mapping Protocol
    Sakineh Dadipoor, Ali Heyrani, Teamur Aghamolaei, Amin Ghanbarnezhad, Mohtasham Ghaffari
    Substance Use & Misuse.2020; 55(11): 1800.     CrossRef
  • Potential causes of male and female infertility in Qatar
    Gerhild Zauner, Guillermina Girardi
    Journal of Reproductive Immunology.2020; 141: 103173.     CrossRef
  • Waterpipe smoking: the pressing need for risk communication
    Wasim Maziak, Olatokunbo Osibogun, Taghrid Asfar
    Expert Review of Respiratory Medicine.2019; 13(11): 1109.     CrossRef
  • Epidemiology and Adverse Consequences of Hookah/Waterpipe Use: A Systematic Review
    Rebecca Pratiti, Debabrata Mukherjee
    Cardiovascular & Hematological Agents in Medicinal Chemistry .2019; 17(2): 82.     CrossRef
The association between physical activity and atrial fibrillation applying the Heaviside function in survival analysis: the Multi-Ethnic Study of Atherosclerosis
Yaser Mokhayeri, Seyed Saeed Hashemi-Nazari, Mohammad Ali Mansournia, Hamid Soori, Soheila Khodakarim
Epidemiol Health. 2017;39:e2017024.   Published online June 18, 2017
DOI: https://doi.org/10.4178/epih.e2017024
  • 15,103 View
  • 203 Download
  • 6 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Although the effect of physical activity (PA) on the incidence of atrial fibrillation (AF) has been studied, contradictory results have been reported. Such discrepancies may reflect the different effects of various types of PA upon AF, as well as gender interactions. Therefore, we aimed to evaluate the associations of PA types (total, moderate/vigorous, and intentional), as well as walking pace, with AF risk in men and women.
METHODS
Using the Multi-Ethnic Study of Atherosclerosis Typical Week Physical Activity Survey, 3 PA measures and walking pace were calculated among 6,487 men and women aged 45-84 years. The incidence of AF over approximately 11 years of followup was ascertained. The association of each PA measure and walking pace with AF incidence was estimated using multivariable Cox proportional hazard models. An extended Cox model with Heaviside functions (hv) of time was used to estimate the effects of time-varying covariates.
RESULTS
During 11 years of follow-up (49,557 person-years), 242 new AF cases occurred. The incidence rate of AF was 48.83 per 10,000 person-years. The proportional hazard (PH) assumption for total PA among women was not met; hence, we used the hv to calculate the hazard ratio. Total PA in women in the hv2 analysis was negatively associated with AF in all 3 models, although for hv1 no significant association was observed. The PH assumption for walking pace among men was not met, and none of the hv showed a statistically significant association between walking pace and AF in men.
CONCLUSIONS
These results suggest that PA is inversely associated with AF in women.
Summary

Citations

Citations to this article as recorded by  
  • Leisure-time and occupational physical activity and risk of cardiovascular disease incidence: a systematic-review and dose-response meta-analysis of prospective cohort studies
    Asma Kazemi, Sepideh Soltani, Dagfinn Aune, Elham Hosseini, Zeinab Mokhtari, Zahra Hassanzadeh, Ahmad Jayedi, Francisco Pitanga, Masoumeh Akhlaghi
    International Journal of Behavioral Nutrition and Physical Activity.2024;[Epub]     CrossRef
  • Impact of ventricular assist device use on pediatric heart transplant waitlist mortality: Analysis of the scientific registry of transplant recipients database
    Arene Butto, Lydia K. Wright, Jameson Dyal, Chad Y. Mao, Richard Garcia, William T. Mahle
    Pediatric Transplantation.2024;[Epub]     CrossRef
  • Weekly physical activity and incident atrial fibrillation in females – A dose-response meta-analysis
    Ioannis Anagnostopoulos, Maria Kousta, Charalampos Kossyvakis, Eleni Lakka, Dimitrios Vrachatis, Spyridon Deftereos, Vassilios P. Vassilikos, Georgios Giannopoulos
    International Journal of Cardiology.2023; 370: 191.     CrossRef
  • Self-Reported Walking Pace and Risk of Cardiovascular Diseases: A Two-Sample Mendelian Randomization Study
    Lu Chen, Xingang Sun, Yuxian He, Liangrong Zheng
    Frontiers in Genetics.2022;[Epub]     CrossRef
  • Sex-Specific Exposure–Effect Relationship Between Physical Activity and Incident Atrial Fibrillation in the General Population: A Dose–Response Meta-Analysis of 16 Prospective Studies
    Qin Wan, Yue Zhou, Wengen Zhu, Xiao Liu
    Frontiers in Cardiovascular Medicine.2021;[Epub]     CrossRef
Exploring neighborhood inequality in female breast cancer incidence in Tehran using Bayesian spatial models and a spatial scan statistic
Erfan Ayubi, Mohammad Ali Mansournia, Ali Ghanbari Motlagh, Alireza Mosavi-Jarrahi, Ali Hosseini, Kamran Yazdani
Epidemiol Health. 2017;39:e2017021.   Published online May 17, 2017
DOI: https://doi.org/10.4178/epih.e2017021
  • 17,297 View
  • 231 Download
  • 13 Web of Science
  • 14 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The aim of this study was to explore the spatial pattern of female breast cancer (BC) incidence at the neighborhood level in Tehran, Iran.
METHODS
The present study included all registered incident cases of female BC from March 2008 to March 2011. The raw standardized incidence ratio (SIR) of BC for each neighborhood was estimated by comparing observed cases relative to expected cases. The estimated raw SIRs were smoothed by a Besag, York, and Mollie spatial model and the spatial empirical Bayesian method. The purely spatial scan statistic was used to identify spatial clusters.
RESULTS
There were 4,175 incident BC cases in the study area from 2008 to 2011, of which 3,080 were successfully geocoded to the neighborhood level. Higher than expected rates of BC were found in neighborhoods located in northern and central Tehran, whereas lower rates appeared in southern areas. The most likely cluster of higher than expected BC incidence involved neighborhoods in districts 3 and 6, with an observed-to-expected ratio of 3.92 (p<0.001), whereas the most likely cluster of lower than expected rates involved neighborhoods in districts 17, 18, and 19, with an observed-to-expected ratio of 0.05 (p<0.001).
CONCLUSIONS
Neighborhood-level inequality in the incidence of BC exists in Tehran. These findings can serve as a basis for resource allocation and preventive strategies in at-risk areas.
Summary

Citations

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    Chawarat Rotejanaprasert, Kawin Chinpong, Andrew B. Lawson, Peerut Chienwichai, Richard J. Maude
    BMC Medical Research Methodology.2024;[Epub]     CrossRef
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    Fatemeh Rajabi, Farhad Hosseinali, Hamidreza Rabiei-Dastjerdi
    Sustainable Cities and Society.2024; 117: 105845.     CrossRef
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    Revista Brasileira de Epidemiologia.2023;[Epub]     CrossRef
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    Payam Kheirmand Parizi, Leila Mousavi Seresht, Seyed-Alireza Esmaeili, Ali Davarpanah Jazi, Abdolazim Sarli, Farinaz Khosravian, Mansour Salehi
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Adjusting for reverse causation to estimate the effect of obesity on mortality after incident heart failure in the Atherosclerosis Risk in Communities (ARIC) study
Maryam Shakiba, Hamid Soori, Mohammad Ali Mansournia, Seyed Saeed Hashemi Nazari, Yahya Salimi
Epidemiol Health. 2016;38:e2016025.   Published online June 4, 2016
DOI: https://doi.org/10.4178/epih.e2016025
  • 17,914 View
  • 245 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The lower mortality rate of obese patients with heart failure (HF) has been partly attributed to reverse causation bias due to weight loss caused by disease. Using data about weight both before and after HF, this study aimed to adjust for reverse causation and examine the association of obesity both before and after HF with mortality.
METHODS
Using the Atherosclerosis Risk in Communities (ARIC) study, 308 patients with data available from before and after the incidence of HF were included. Pre-morbid and post-morbid obesity were defined based on body mass index measurements at least three months before and after incident HF. The associations of pre-morbid and post-morbid obesity and weight change with survival after HF were evaluated using a Cox proportional hazard model.
RESULTS
Pre-morbid obesity was associated with higher mortality (hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.04 to 2.49) but post-morbid obesity was associated with increased survival (HR, 0.57; 95% CI, 0.37 to 0.88). Adjusting for weight change due to disease as a confounder of the obesity-mortality relationship resulted in the absence of any significant associations between post-morbid obesity and mortality.
CONCLUSIONS
This study demonstrated that controlling for reverse causality by adjusting for the confounder of weight change may remove or reverse the protective effect of obesity on mortality among patients with incident HF.
Summary

Citations

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    Lu Wang, Xin Du, Jian-Zeng Dong, Wen-Na Liu, Ying-Chun Zhou, Song-Nan Li, Xue-Yuan Guo, Chen-Xi Jiang, Rong-Hui Yu, Cai-Hua Sang, Ri-Bo Tang, De-Yong Long, Nian Liu, Rong Bai, Laurent Macle, Chang-Sheng Ma
    Clinical Research in Cardiology.2019; 108(12): 1371.     CrossRef
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    American Journal of Epidemiology.2019; 188(10): 1838.     CrossRef
Method
Assessing measurement error in surveys using latent class analysis: application to self-reported illicit drug use in data from the Iranian Mental Health Survey
Kazem Khalagi, Mohammad Ali Mansournia, Afarin Rahimi-Movaghar, Keramat Nourijelyani, Masoumeh Amin-Esmaeili, Ahmad Hajebi, Vandad Sharif, Reza Radgoodarzi, Mitra Hefazi, Abbas Motevalian
Epidemiol Health. 2016;38:e2016013.   Published online April 10, 2016
DOI: https://doi.org/10.4178/epih.e2016013
  • 17,219 View
  • 260 Download
AbstractAbstract PDF
Abstract
Latent class analysis (LCA) is a method of assessing and correcting measurement error in surveys. The local independence assumption in LCA assumes that indicators are independent from each other condition on the latent variable. Violation of this assumption leads to unreliable results. We explored this issue by using LCA to estimate the prevalence of illicit drug use in the Iranian Mental Health Survey. The following three indicators were included in the LCA models: five or more instances of using any illicit drug in the past 12 months (indicator A), any use of any illicit drug in the past 12 months (indicator B), and the self-perceived need of treatment services or having received treatment for a substance use disorder in the past 12 months (indicator C). Gender was also used in all LCA models as a grouping variable. One LCA model using indicators A and B, as well as 10 different LCA models using indicators A, B, and C, were fitted to the data. The three models that had the best fit to the data included the following correlations between indicators: (AC and AB), (AC), and (AC, BC, and AB). The estimated prevalence of illicit drug use based on these three models was 28.9%, 6.2% and 42.2%, respectively. None of these models completely controlled for violation of the local independence assumption. In order to perform unbiased estimations using the LCA approach, the factors violating the local independence assumption (behaviorally correlated error, bivocality, and latent heterogeneity) should be completely taken into account in all models using well-known methods.
Summary
Original Articles
Associations between diabetes self-management and microvascular complications in patients with type 2 diabetes
Fatemeh Mehravar, Mohammad Ali Mansournia, Kourosh Holakouie-Naieni, Ensie Nasli-Esfahani, Nasrin Mansournia, Amir Almasi-Hashiani
Epidemiol Health. 2016;38:e2016004.   Published online January 25, 2016
DOI: https://doi.org/10.4178/epih.e2016004
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  • 295 Download
  • 34 Web of Science
  • 25 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Diabetes is a major public health problem that is approaching epidemic proportions globally. Diabetes self-management can reduce complications and mortality in type 2 diabetic patients. The purpose of this study was to examine associations between diabetes self-management and microvascular complications in patients with type 2 diabetes.
METHODS
In this cross-sectional study, 562 Iranian patients older than 30 years of age with type 2 diabetes who received treatment at the Diabetes Research Center of the Endocrinology and Metabolism Research Institute of the Tehran University of Medical Sciences were identified. The participants were enrolled and completed questionnaires between January and April 2014. Patients’ diabetes self-management was assessed as an independent variable by using the Diabetes Self-Management Questionnaire translated into Persian. The outcomes were the microvascular complications of diabetes (retinopathy, nephropathy, and neuropathy), identified from the clinical records of each patient. A multiple logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) between diabetes self-management and the microvascular complications of type 2 diabetes, adjusting for potential confounders.
RESULTS
After adjusting for potential confounders, a significant association was found between the diabetes self-management sum scale and neuropathy (adjusted OR, 0.64; 95% CI, 0.45 to 0.92, p=0.01). Additionally, weak evidence was found of an association between the sum scale score of diabetes self-management and nephropathy (adjusted OR, 0.71; 95% CI, 0.47 to 1.05, p=0.09).
CONCLUSIONS
Among patients with type 2 diabetes, a lower diabetes self-management score was associated with higher rates of nephropathy and neuropathy.
Summary

Citations

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  • Relationship Between COVID-19-related Factors and Self-management Behaviors in People with Type-2 Diabetes: A Cross-sectional Study
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Risk factors for amputation in patients with diabetic foot ulcer in southwest Iran: a matched case-control study
Mohammad Kogani, Mohammad Ali Mansournia, Amin Doosti-Irani, Kourosh Holakouie-Naieni
Epidemiol Health. 2015;37:e2015044.   Published online October 5, 2015
DOI: https://doi.org/10.4178/epih/e2015044
  • 21,180 View
  • 293 Download
  • 16 Web of Science
  • 15 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Amputation is a multifactorial complication in diabetic patients. The aim of this study was to determine the risk factors associated with amputation in patients with diabetic foot ulcers.
METHODS
This matched case-control study was conducted based on new cases of amputation from March 2012 to November 2014. We selected new cases who had undergone amputation, and the control group was chosen from the cities or areas where the cases resided. Each case was matched with two controls based on the duration of diabetes and location. Conditional logistic regression was used to evaluate the associations between potential risk factors and amputation.
RESULTS
A total of 131 cases were compared with 262 controls. The results of the adjusted model showed that sex (odds ratio [OR], 8.66; 95% confidence interval [CI], 2.68 to 27.91), fewer than two hemoglobin A1c (HbA1c) tests per year (OR, 13.97; 95% CI, 4.97 to 39.26), unsuitable shoes (OR, 5.50; 95% CI, 2.20 to 13.77), smoking (OR, 3.44; 95% CI, 1.45 to 8.13), and body mass index (OR, 1.20; 95% CI, 1.03 to 1.41) were associated with amputation in diabetic patients.
CONCLUSIONS
The most important factors associated with amputation were females, irregular monitoring of HbA1c levels, improper footwear, and smoking. Developing educational programs and working to ensure a higher quality of care for diabetic patients are necessary steps to address these issues.
Summary

Citations

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