Incidence and associated risk factors for premature death in the Tehran Lipid and Glucose Study cohort, Iran
Abstract Background The incidence and associated risk factors for premature death were investigated in a population-based cohort study in Iran. Methods A total of 7245 participants (3216 men), aged 30–70 years, were included. We conducted Cox proportional hazards models to identify the risk factors...
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BMC
2019-06-01
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| Series: | BMC Public Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12889-019-7056-y |
| _version_ | 1818885747822821376 |
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| author | Ali Eslami Seyed Sina Naghibi Irvani Azra Ramezankhani Nazanin Fekri Keyvan Asadi Fereidoun Azizi Farzad Hadaegh |
| author_facet | Ali Eslami Seyed Sina Naghibi Irvani Azra Ramezankhani Nazanin Fekri Keyvan Asadi Fereidoun Azizi Farzad Hadaegh |
| author_sort | Ali Eslami |
| collection | DOAJ |
| description | Abstract Background The incidence and associated risk factors for premature death were investigated in a population-based cohort study in Iran. Methods A total of 7245 participants (3216 men), aged 30–70 years, were included. We conducted Cox proportional hazards models to identify the risk factors for premature death. For each risk factor, hazard ratio (HR), 95% confidence intervals (95% CI) and population attributable fraction (PAF) were calculated. Results After a median follow-up of 13.8 years, 262 premature deaths (153 in men) occurred. Underlying causes of premature deaths were cardiovascular disease (CVD) (n = 126), cancer (n = 51), road injuries (n = 15), sepsis and pneumonia (n = 9) and miscellaneous reasons (n = 61). The age-standardized incident rate of premature death was 2.35 per 1000 person years based on WHO standard population. Hypertension [HR 1.40, 95% CI (1.07–1.83)], diabetes (2.53, 1.94–3.29) and current smoking (1.58, 1.16–2.17) were significant risk factors for premature mortality; corresponding PAFs were 12.3, 22.4 and 9.2%, respectively. Overweight (body mass index (BMI): 25–29.9 kg/m2) (0.65, 0.49–0.87) and obesity (BMI ≥30 kg/m2) (0.67, 0.48–0.94) were associated with decreased premature mortality. After replacing general adiposity with central adiposity, we found no significant risk for the latter (0.92, 0.71–1.18). Moreover, when we excluded current smokers, those with prevalent cancer/cardiovascular disease and those with survival of less than 3 years, the inverse association between overweight (0.59, 0.39–0.88) and obesity (0.67, 0.43–1.04), generally remained unchanged; although, diabetes still showed a significant risk (2.62, 1.84–3.72). Conclusions Controlling three modifiable risk factors including diabetes, hypertension and smoking might potentially reduce mortality events by over 40%, and among these, prevention of diabetes should be prioritized to decrease burden of events. We didn’t confirm a negative impact of overweight and obesity status on premature mortality events. |
| first_indexed | 2024-12-19T16:10:22Z |
| format | Article |
| id | doaj.art-c9fe8fb5a6e040c4bc52fb96f72ec039 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-19T16:10:22Z |
| publishDate | 2019-06-01 |
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| spelling | doaj.art-c9fe8fb5a6e040c4bc52fb96f72ec0392022-12-21T20:14:45ZengBMCBMC Public Health1471-24582019-06-011911710.1186/s12889-019-7056-yIncidence and associated risk factors for premature death in the Tehran Lipid and Glucose Study cohort, IranAli Eslami0Seyed Sina Naghibi Irvani1Azra Ramezankhani2Nazanin Fekri3Keyvan Asadi4Fereidoun Azizi5Farzad Hadaegh6Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesPrevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesPrevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesPrevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesPrevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesEndocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesPrevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesAbstract Background The incidence and associated risk factors for premature death were investigated in a population-based cohort study in Iran. Methods A total of 7245 participants (3216 men), aged 30–70 years, were included. We conducted Cox proportional hazards models to identify the risk factors for premature death. For each risk factor, hazard ratio (HR), 95% confidence intervals (95% CI) and population attributable fraction (PAF) were calculated. Results After a median follow-up of 13.8 years, 262 premature deaths (153 in men) occurred. Underlying causes of premature deaths were cardiovascular disease (CVD) (n = 126), cancer (n = 51), road injuries (n = 15), sepsis and pneumonia (n = 9) and miscellaneous reasons (n = 61). The age-standardized incident rate of premature death was 2.35 per 1000 person years based on WHO standard population. Hypertension [HR 1.40, 95% CI (1.07–1.83)], diabetes (2.53, 1.94–3.29) and current smoking (1.58, 1.16–2.17) were significant risk factors for premature mortality; corresponding PAFs were 12.3, 22.4 and 9.2%, respectively. Overweight (body mass index (BMI): 25–29.9 kg/m2) (0.65, 0.49–0.87) and obesity (BMI ≥30 kg/m2) (0.67, 0.48–0.94) were associated with decreased premature mortality. After replacing general adiposity with central adiposity, we found no significant risk for the latter (0.92, 0.71–1.18). Moreover, when we excluded current smokers, those with prevalent cancer/cardiovascular disease and those with survival of less than 3 years, the inverse association between overweight (0.59, 0.39–0.88) and obesity (0.67, 0.43–1.04), generally remained unchanged; although, diabetes still showed a significant risk (2.62, 1.84–3.72). Conclusions Controlling three modifiable risk factors including diabetes, hypertension and smoking might potentially reduce mortality events by over 40%, and among these, prevention of diabetes should be prioritized to decrease burden of events. We didn’t confirm a negative impact of overweight and obesity status on premature mortality events.http://link.springer.com/article/10.1186/s12889-019-7056-yPremature mortalityRisk factorsCohort studyPopulation attributable fractionsIncidence |
| spellingShingle | Ali Eslami Seyed Sina Naghibi Irvani Azra Ramezankhani Nazanin Fekri Keyvan Asadi Fereidoun Azizi Farzad Hadaegh Incidence and associated risk factors for premature death in the Tehran Lipid and Glucose Study cohort, Iran BMC Public Health Premature mortality Risk factors Cohort study Population attributable fractions Incidence |
| title | Incidence and associated risk factors for premature death in the Tehran Lipid and Glucose Study cohort, Iran |
| title_full | Incidence and associated risk factors for premature death in the Tehran Lipid and Glucose Study cohort, Iran |
| title_fullStr | Incidence and associated risk factors for premature death in the Tehran Lipid and Glucose Study cohort, Iran |
| title_full_unstemmed | Incidence and associated risk factors for premature death in the Tehran Lipid and Glucose Study cohort, Iran |
| title_short | Incidence and associated risk factors for premature death in the Tehran Lipid and Glucose Study cohort, Iran |
| title_sort | incidence and associated risk factors for premature death in the tehran lipid and glucose study cohort iran |
| topic | Premature mortality Risk factors Cohort study Population attributable fractions Incidence |
| url | http://link.springer.com/article/10.1186/s12889-019-7056-y |
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