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To estimate the prevalence and trends of diabetes mellitus (DM) and impaired fasting glucose (IFG), 2005-2011, and to determine the contribution of obesity to DM prevalence.Data from Surveillance of Risk Factors of Non-communicable Diseases (SuRFNCD) conducted in 2005, 2007, and 2011 were gathered. DM was defined as presence of self-reported previous diagnosis or a fasting plasma glucose (FPG)≥7 mmol/L. IFG was diagnosed with FPG levels between 5.6 and 6.9 mmol/L. Prevalence rates for 2011 and trends for 2005-2011 were determined by extrapolating survey results to Iran's adult population. Population attributable fraction (PAF) of obesity was also calculated.In 2011, IFG and total DM prevalence rates were 14.60% (95%CI: 12.41-16.78) and 11.37% (95%CI: 9.86-12.89) among 25-70 years, respectively. DM was more common in older age (p0.0001), in women (p = 0.0216), and in urban-dwellers (p = 0.0001). In 2005-2011, trend analysis revealed a 35.1% increase in DM prevalence (OR: 1.04, 95%CI: 1.01-1.07, p = 0.011); albeit, IFG prevalence remained relatively unchanged (OR: 0.98, 95%CI: 0.95-1.00, p = 0.167). In this period, DM awareness improved; undiagnosed DM prevalence decreased from 45.7% to 24.7% (p0.001). PAF analysis demonstrated that 33.78%, 10.25%, and 30.56% of the prevalent DM can be attributed to overweight (BMI≥25kg/m(2)), general obesity (BMI≥30 kg/m(2)), and central obesity (waist circumference≥90 cm), respectively. Additionally, the DM increase rate in 2005-2011, was 20 times higher in morbidly obese compared with lean individuals.More than four million Iranian adults have DM which has increased by 35% over the past seven years, owing in large part, to expanding obesity epidemic.

We assessed the threshold of homeostasis model assessment (HOMA) values to determine insulin resistance (IR) in a sample of Iranians and examined the associations of IR with metabolic syndrome (MetS). Study comprised 1327 non-diabetic and non-hypertensive subjects (438 men, 838 women; aged 20-77 years) incurred in four different locations (Tehran, Iran), 2005-2008. Lower limit of the top quintile of HOMA values in subjects without any metabolic abnormality was considered as the threshold of IR. This threshold was 1.8 (1.7 men; 1.8 women). Overall, 41.1% (36.3% men; 41.5% women) of subjects had IR. HOMA cut-off to determine MetS was 1.95 for ATPIII definition, and 1.85 for IDF. IR associated MetS (ATPIII: odds ratio (OR)=2.9, 95% CI=2.2-3.9, p0.05; IDF: OR=2.94, 95% CI: 2.3-3.8, p0.05). Sensitivity of MetS to detect IR was 22.4% for IDF and 36.2% for ATPIII criteria. In multivariate models, HOMA was predicted by waist circumference, and inversely by age and serum HDL-cholesterol. In this study, the cut point of HOMA to detect IR was lower than other populations. IR is an unyielding correlate of MetS; but definitions of MetS are insensitive measures of IR in our population.

Aims Central obesity, a prominent feature of metabolic syndrome (MetS), is commonly assessed by gender- and ethnicity-specific waist circumference (WC) cut-off values. Since 2006, the recommended WC cut-offs by the International Diabetes Federation (IDF) for Europeans are used in Iran because of limited data availability. The purpose of this study was to determine optimal cut-off points for the diagnosis of MetS in Iran. Methods A total of 2752 adults (1046 men) were studied. Subjects with two or more of the following risk factors from the IDF criteria were considered to have multiple risk factors: hyperglycemia (FBG ≥ 100 mg/dL or diagnosed diabetes), high blood pressure (SBP ≥ 130 mmHg, DBP ≥ 85 mmHg, or using antihypertensive drugs), low HDL ( 150 mg/dL). Results The WC cut-off yielding maximum sensitivity plus specificity for predicting the presence of multiple risk factors was 91.5 cm in men and 85.5 cm in women. Sensitivity and specificity were 77% (86%) and 58% (50%) in men (women), respectively. MetS prevalence was estimated to be approximately 27% in Tehran. Conclusions WC cut-offs recommended by the IDF are not appropriate for use in Iran.

The aim of this study was to evaluate the association of serum visfatin, adiponectin and leptin with 2 diabetes mellitus (T2DM) in the context of the role of obesity or insulin resistance, which is not well understood.A total of 76 newly-diagnosed T2DM patients and 76 healthy control subjects, matched for age, body mass index (BMI) and sex ratio, were enrolled. Anthropometric parameters, glycemic and lipid profile, insulin resistance (measured by homeostasis model assessment of insulin resistance index [HOMA-IR]), leptin, adiponectin, and visfatin were assessed.On the contrary to adiponectin, serum leptin and visfatin levels were higher in T2DM patients compared with controls (10.07 ± 4.5, 15.87 ± 16.4, and 5.49 ± 2.4 vs. 12.22 ± 4.9 μg/ml, 8.5 ± 7.8 ng/ml and 3.58 ± 2.2 ng/ml, respectively, P0.01). Waist circumference and BMI were correlated with leptin and adiponectin but not with visfatin. Leptin, adiponectin and visfatin all were associated with T2DM following adjusting for obesity measures. After controlling for HOMA-IR, visfatin remained as an independent predictor of T2DM (odds ratio=1.32, P0.05). In a multiple regression analysis to determine visfatin only triglycerides and fasting glucose remained in the model (P0.05).Elevation of visfatin in T2DM is independent of obesity and insulin resistance and is mainly determined by fasting glucose and triglycerides.