صفحه اصلي > مراکز تحقيقات > مرکز تحقيقات پيشگيري از بيماريهاي متابوليک

 

بسمه تعالي
Prevention of Metabolic DisordersResearch Center
 
 نام مرکز
مرکز تحقيقات پيشگيري از بيماري­هاي متابوليک
Prevention of Metabolic DisordersResearch Center
 
تاريخچه
تاريخ تصويب مركز تحقيقات پيشگيري از بيماري­هاي متابوليك در شوراي گسترش دانشگاه­هاي علوم پزشکي معاونت تحقيقات و فن آوري 14/5/87 مي­باشد.
 
  اهداف و اولويت­ها
اين مرکز به عنوان يکي از مراکز پژوهشکده علوم غدد درون ريز و متابوليسم در قالب سياست­ها و اهداف کلي پژوهشکده رسالت پژوهش در زمينه­هاي اپيدميولوژي، علوم پايه و باليني انواع اختلالات متابوليک از جمله بيماري ديابت، وضعيت­هاي پره ديابتي، سندرم متابوليک و اختلالات قلبي- عروقي مربوطه را به عهده دارد. با توجه به گسترش زمينه­هاي پژوهش در پژوهشکده، به منظور ايجاد روندي منظم و جهت دار براي تحقيقات به نحوي که در راستاي رفع نيازها و مشکلات بهداشتي- درماني کشور باشد، مرکز تحقيقات پيشگيري از بيماري­هاي متابوليک نياز به تعيين اولويت­هاي تحقيقاتي خود داشته که پس از نيازسنجي در زمينه­هاي علوم پايه، باليني و اپيدميولوژي و با بهره­گيري از منابع مختلف از جمله نظريات مرکز مبارزه با بيماري­ها، اطلاعات مربوط به اولويت­هاي تحقيقاتي کميسيون پزشکي شوراي پژوهش­هاي علمي کشور، آئين­نامه­ها و مقررات پژوهشي معاونت پژوهشي وزارت بهداشت، درمان و آموزش پزشکي، معاونت پژوهشي دانشگاه علوم پزشکي شهيد بهشتي و ساير منابع (نظرات افراد صاحب­نظر، شاخص­هاي اجتماعي و مصاحبه­ها و...) اقدام به اولويت بندي موضوعات پژوهشي خود نموده است.
اساسنامه مرکز:
1-     تمرکز بر پژوهش­هاي بنيادي، اپيدميولوژيک و باليني در زمينه پيشگيري از ديابت، اختلالات متابوليک و بيماري­هاي غيرواگير مرتبط با شيوه زندگي
2-     ارتقاي اعتبار دانش بنيادي جديد و زمينه کاربردي آن در عرصه باليني از طريق پژوهش­هاي مستدل و بديعي که در زمينه­هاي باليني، اپيدميولوژيک و پيامدها صورت مي­پذيرد
3-     ارزيابي، تصحيح و انتشار دانش جديد باليني در زمينه ديابت و اختلالات متابوليک مرتبط با آن به منظور اصلاح نظام ارائه خدمات بهداشتي- درماني در اجتماع به ويژه در جمعيت­هاي در معرض خطر
4-     بکارگيري آموزش، ايجاد انگيزه و بازآموزي براي محققين علوم پايه و باليني و همچنين افراد آموزش ديده در زمينه مراقبت­هاي بهداشتي ديابت، بيماري­هاي متابوليک و ساير بيماري­هاي غيرواگير
5-     کوشش در جلب همکاري مراکز تحقيقاتي و اجرايي مربوطه در داخل کشور
6-     همکاري علمي با مراکز تحقيقاتي و آموزشي ساير کشورها و سازمان­هاي بين­المللي با رعايت قوانين و مقررات دولت جمهوري اسلامي ايران
 اولويت­هاي طرح­هاي تحقيقات مرکز به تفکيک عناوين کلي:
1-     ديابت 
2-اختلالات متابوليک غير ديابتي در بزرگسالان
3-عوامل خطر پيامدهاي قلبي- عروقي 
4-اختلالات متابوليک کودکان (غيرمادرزادي)
■ برنامه­هاي راهبردي مرکز:
1-     تهيه و تدوين برنامه عملياتي و ايجاد کميته هاي دانشجويي پژوهشي
2-     طراحي بسته­هاي آموزشي کاربردي متناسب با گروه­هاي هدف
3-     طراحي و اجراي کارگاه آموزشي براي عموم
4-     طراحي پروژه ملي در راستاي اهداف چشم انداز و نقشه جامع علمي سلامت
5-     همکاري تخصصي با مراکز تحقيقاتي و يا بخش­هاي مرتبط خارج از دانشگاه
6-     اجرا و افزايش پروژه­هاي منطقه اي - بين­المللي درخارج ازکشور
7-     ارائه خلاصه مقالات درکنگره­هاي بين­المللي
■ اقدامات مهم انجام شده در مرکز:
1-     توليد علم از طريق انتشار بيش از 70 مقاله مندرج در ISI
2-     برگزاري سمپوزيوم و کارگاه­هاي بيماري­هاي متابويک با تأکيد بر بيماري ديابت
3-     تعيين حدود طبيعي دورکمر با مطالعات بر اساس پيامدهاي قلبي- عروقي و تأييد آن در کميته کشوري
4-     تعيين اعتبار مدل­هاي پيش­بيني بيماري­هاي قلبي- عروقي، ديابت و فشار خون براي اولين بار در کشور
5-     برگزاري کارگاه­هاي تخصصي اپيدميولوژي، آمار و متدولوژي در زمينه پژوهش در بيماري­هاي غيرواگير      
  رزومه رئيس مرکز
    ôمشخصات فردي:
·        نام و نام خانوادگي : فرزاد حدائق
·        تاريخ تولد: 1346
·        محل تولد: تهران
·        نام و نشاني محل كار: تهران، پژوهشكده علوم غدد درون ريز و متابوليسم، مركز تحقيقات پيشگيري از بيماريهاي متابوليك
·        تلفن محل كار:22432500
·        شغل: عضو هيئت علمي، رئيس مرکز تحقيقات پيشگيري از بيماري‌هاي متابوليک
·        مرتبه علمي: استاد
 
 
ô حوزه پژوهشي:
-        دو طرح در حال اجرا:
1-    تعيين مهمترين دسته از عوامل خطر براي بيماري­هاي قلبي عروقي در مطالعه قند و ليپيد تهران
2-    تعيين عوامل خطر ابتلا به ديابت نوع 2 در افراد بالاي 20 سال به روش داده کاوي مطالعه قند و ليپيد تهران
 
-        دو طرح خاتمه يافته:
  
-        پنج عنوان مقاله چاپ شده اخير:
1- A simple clinical model predicted diabetes progression among prediabetic individuals.
2- Non-linear contribution of glucose measures to cardiovascular diseases and mortality: Reclassifying the Framingham's risk categories: A decade follow-up from the Tehran lipid and glucose study.
3- Does an electrocardiogram add predictive value to the rose angina questionnaire for future coronary heart disease? 10-year follow-up in a Middle East population.
4- Prognostic significance of the Complex "Visceral Adiposity Index" vs. simple anthropometric measures: Tehran Lipid and Glucose Study.
5- Electrocardiographic abnormalities improve classification of coronary heart disease risk in women: Tehran Lipid and Glucose Study.
 
 
 چکيده پنج مقاله اخير
* A simple clinical model predicted diabetes progression among prediabetic individuals
Abstract:
We followed 1372 prediabetic individuals aged ≥20years and documented 278 incident diabetes cases. Family history of diabetes, blood pressure, waist, high-density lipoprotein cholesterol, and FPG independently associated with diabetes progression among women. Among men, family history of premature CVD, waist, and FPG remained independently associated with diabetes progression.
 
* Non-linear contribution of glucose measures to cardiovascular diseases and mortality: Reclassifying the Framingham's risk categories: A decade follow-up from the Tehran lipid and glucose study.
Abstract:
Background:
 We investigated non-linear contribution of fasting plasma glucose (FPG) and 2-hour post-challenge plasma glucose (2h-PCPG) to the risk of CVD and mortality. We hypothesized that glucose measures improve risk-stratification made by the Framingham's general CVD risk algorithm.
Methods:
Among participants aged ≥30 (n=8071), not taking glucose-lowering agents, 6169 (3477 women) remained eligible. Non-linear contribution of FPG and 2h-PCPG to incident CVD and mortality were assessed using Cox models incorporating restricted cubic splines functions. Risk reclassification improvement conferred by FPG and 2h-PCPG was examined using an extended version of net reclassification index (NRI) that takes into account the censoring nature of survival data.
Results:
We documented 465 incident CVD events (402 CHD), 212 deaths from any cause (94 CVD deaths). Excluding the contribution of the 2h-PCGP to mortality (that was linear) dose-response relationships between glucose measures and CVD and mortality were curvilinear with nadirs below which decreasing levels of glucose were unlikely to offer any benefit. These nadirs were assigned to FPG of 4.9-5.3 and 2h-PCPG of 6.0mmol.l(-1). Glucose measures added to the predictive ability of the Framingham's general CVD risk algorithm with cutpoint-free NRIs ranging from 19 to 54%.
Conclusion:
Glucose measures contributed to the risk of CVD and mortality in a curvilinear fashion, we observed increased risk below glucose thresholds currently used to define diabetes, supporting criteria for the diagnosis of impaired fasting glycemia and impaired glucose tolerance. Glucose measures were observed to add to predictive ability of the predictive model which included established cardiovascular risk factors.
 
* Does an electrocardiogram add predictive value to the rose angina questionnaire for future coronary heart disease? 10-year follow-up in a Middle East population.
Abstract:
BackgroundTo evaluate the power of abnormal resting ECG versus Rose Questionnaire angina and its additive value in predicting 10-year coronary heart disease (CHD) risk in an Iranian urban population with high prevalence of CHD.MethodsThere were 5101 subjects ≥30 years (2900 women), free of CHD at baseline; they were categorised in to four groups according to their Rose Angina and ECG status for ischaemia as Rose-/ECG-, Rose+/ECG-, Rose-/ECG+ and Rose+/ECG+. HR of CHD was estimated using Cox regression analysis, given Rose-/ECG- as the reference. The authors used Akaike information criterion, C-index and integrated discrimination improvement indices to evaluate the prognostic value of ECG when would be added to Rose Questionnaire.ResultsDuring follow-up, 387 CHD events (169 women) were observed. Multivariate analysis showed a HR of 2.59 (95% CI 1.71 to 3.91) and 2.26 (1.48 to 3.44) for Rose+/ECG- group in men and women, respectively. These figures for Rose-/ECG+ were 1.36 (0.90 to 2.05) in men and 2.09 (1.40 to 3.12) in women. There was no any interaction between Rose Questionnaire and gender to predict incident CHD, in age-adjusted analysis. Akaike information criterion, C-index and relative integrated discrimination improvement did not show any difference between models including Rose alone and Rose plus ECG to predict CHD events especially in men.ConclusionsRose Questionnaire as a simple screening tool is equally important to predict incident CHD in both genders. Adding abnormal ECG to angina did not culminate in higher risk for future CHD events.
 
* Prognostic significance of the Complex "Visceral Adiposity Index" vs. simple anthropometric measures: Tehran Lipid and Glucose Study.
Abstract:
Background:
Visceral adiposity index (VAI) has recently been suggested to be used as a surrogate of visceral adiposity. We examined if VAI could improve predictive performances for CVD of the Framingham's general CVD algorithm (a multivariate model incorporating established CVD risk factors). We compared the predictive abilities of the VAI with those of simple anthropometric measures i.e. BMI, waist-to-height ratio (WHtR) or waist-to-hip ratio (WHpR). Design and methods In a nine-year population-based follow-up, 6 407 (2 778 men) participants, free of CVD at baseline, aged [greater than or equal to] 30 years were eligible for the current analysis. The risk of CVD was estimated by incorporating VAI, BMI, WHpR, and WHtR, one at a time, into multivariate accelerated failure time models.
Results:
We documented 534 CVD events with the annual incidence rate (95%CIs) being 7.3 (6.4-8.3) among women and 13.0 (11.7-14.6) among men. Risk of future CVD increased with increasing levels of VAI among both men and women. VAI was associated with multivariate-adjusted increased risk of incident CVD among women. However, the magnitude of risk conferred by VAI was not significantly higher than those conferred by BMI, WHpR, or WHtR. Among men, after adjustment for established CVD risk factors, VAI was no longer associated with increased risk of CVD. VAI failed to add to the predictive ability of the Framingham general CVD algorithm.
Conclusion:
Using VAI instead of simple anthropometric measures may lead to loss of much information needed for predicting incident CVD.
 
* Electrocardiographic abnormalities improve classification of coronary heart disease risk in women: Tehran Lipid and Glucose Study.
Abstract:
Objectives:
To examine the added value of electrocardiogram (ECG) abnormalities beyond the Framingham risk score (FRS) in risk stratification for coronary heart disease (CHD) in a population of Middle Eastern women.
Methods:
 The study population consisted of 2568 women aged ≥30 years, free from CHD symptoms and with no major Q or QS wave or complete left-bundle branch block in their baseline ECG. ECG abnormalities included ST depression (Minnesota codes 4.1-4.2), or T-wave items (Minnesota codes 5.1-5.2). Participants were categorized into 3 groups, according to their FRS. Cox regression analysis was used to estimate the hazard ratios (HR) of CHD events for ECG abnormalities among each FRS group. Net Reclassification Index (NRI) was used as the measure of predictive ability added to the FRS by ECG abnormalities.
Results:
During 9.3 years, 127 CHD events occurred. In the FRS adjusted analysis, the HRs (95%CI) of CHD events were 3.69 (0.87-15.68), 3.82 (2.01-7.23) and 1.39 (0.47-4.16) for ECG abnormalities in each FRS category (i.e. 0-4.9%, 5-19.9 and ≥20%, respectively). Addition of ECG abnormalities to FRS did not significantly increase the C-statistics (0.838), but improved the predictive ability of the FRS by 20.8 (95% CIs 5.0-38.9) using the cut point free NRI.
Conclusion:
Among women, only in the intermediate risk group, ECG abnormalities were independently associated with increased risk of developing CHD. Addition of the ECG abnormalities to the FRS improved the classification of coronary heart disease risk, especially in this group.
 
 
  عناوين پژوهش­هاي انجام شده 3 سال اخير
1- A simple clinical model predicted diabetes progression among prediabetic individuals.
2- Non-linear contribution of glucose measures to cardiovascular diseases and mortality: Reclassifying the Framingham's risk categories: A decade follow-up from the Tehran lipid and glucose study.
3- Does an electrocardiogram add predictive value to the rose angina questionnaire for future coronary heart disease? 10-year follow-up in a Middle East population.
4- Prognostic significance of the Complex "Visceral Adiposity Index" vs. simple anthropometric measures: Tehran Lipid and Glucose Study.
5- Electrocardiographic abnormalities improve classification of coronary heart disease risk in women: Tehran Lipid and Glucose Study.
6.Do different metabolic syndrome definitions predict cerebrovascular events and coronary heart disease independent of their components?: 9 years follow-up of the tehran lipid and glucose study.
7- Evaluation of cause of deaths' validity using outcome measures from a prospective, population based cohort study in Tehran, Iran.
8- Prediction of cardiovascular events with consideration of general and central obesity measures in diabetic adults: results of the 8.4-year follow-up.
9- High normal blood pressure is an independent risk factor for cardiovascular disease among middle-aged but not in elderly populations: 9-year results of a population-based study.
10-Electrocardiography-defined silent CHD and risk of cardiovascular events among diabetic patients in a Middle Eastern population.
11-Hypertriglyceridemic waist: The point of divergence for prediction of CVD vs. mortality: Tehran Lipid and Glucose Study.
12- Triglycerides and triglycerides to high-density lipoprotein cholesterol ratio are strong predictors of incident hypertension in Middle Eastern women.
13- A point-score system superior to blood pressure measures alone for predicting incident hypertension: Tehran Lipid and Glucose Study.
14- Systolic and diastolic blood pressure, mean arterial pressure and pulse pressure for prediction of cardiovascular events and mortality in a Middle Eastern population.
15- Impact of hip circumference and height on incident diabetes: results from 6-year follow-up in the Tehran Lipid and Glucose Study.
16- Predictive performance of the visceral adiposity index for a visceral adiposity-related risk: type 2 diabetes.
17- Fasting glucose cutoff point: where does the risk terminate? Tehran lipid and glucose study.
18-"Predictability of body mass index for diabetes: affected by the presence of metabolic syndrome?".
19- Cardiovascular risk and all-cause mortality attributable to diabetes: Tehran lipid and glucose study.
20- Predictive accuracy of the 'Framingham's general CVD algorithm' in a Middle Eastern population: Tehran Lipid and Glucose Study.
21-Family history of diabetes modifies the effect of blood pressure for incident diabetes in Middle Eastern women: Tehran Lipid and Glucose Study.
22-Intra-erythrocyte magnesium is associated with gamma-glutamyl transferase in obese children and adolescents.
23-Association of educational status with cardiovascular disease: Teheran Lipid and Glucose Study.
24- New and known type 2 diabetes as coronary heart disease equivalent: results from 7.6 year follow up in a Middle East population.
25- Transportability of the updated diabetes prediction model from Atherosclerosis Risk in Communities Study to a Middle Eastern adult population: community-based cohort study.
26- A new approach to compare the predictive power of metabolic syndrome defined by a joint interim statement versus its components for incident cardiovascular disease in Middle East Caucasian residents in Tehran.
27- Predictive performances of lipid accumulation product vs. adiposity measures for cardiovascular diseases and all-cause mortality, 8.6-year follow-up: Tehran lipid and glucose study.
28- Appropriate definition of metabolic syndrome among Iranian adults: report of the Iranian National Committee of Obesity.
29-Lipid ratios and appropriate cut off values for prediction of diabetes: a cohort of Iranian men and women.
30- A simple risk score effectively predicted type 2 diabetes in Iranian adult population: population-based cohort study.
31- Pulse pressure and systolic blood pressure are powerful independent predictors of cardiovascular disease in diabetic adults: results of an 8.4 years follow-up of Tehran Lipid and Glucose Study (TLGS).
32- Reduction in incidence of type 2 diabetes by lifestyle intervention in a middle eastern community.
33- Diabetes prediction, lipid accumulation product, and adiposity measures; 6-year follow-up: Tehran lipid and glucose study.
34- Appropriate waist circumference cut-off points among Iranian adults: the first report of the Iranian National Committee of Obesity.
35- San Antonio heart study diabetes prediction model applicable to a Middle Eastern population? Tehran glucose and lipid study.
36- Waist circumference has heterogeneous impact on development of diabetes in different populations: longitudinal comparative study between Australia and Iran.
37- Lipid measures for prediction of incident cardiovascular disease in diabetic and non-diabetic adults: results of the 8.6 years follow-up of a population based cohort study.
38- Impact of metabolic syndrome, diabetes and prediabetes on cardiovascular events: Tehran lipid and glucose study.
39- ropriate cutoff values of anthropometric variables to predict cardiovascular outcomes: 7.6 years follow-up in an Iranian population.
40- Glucose intolerance and risk of cardiovascular disease in Iranian men and women: results of the 7.6-year follow-up of the Tehran Lipid and Glucose Study (TLGS).
41- Population-based incidence of Type 2 diabetes and its associated risk factors: results from a six-year cohort study in Iran.
42- Prevalence of coronary heart disease among Tehran adults: Tehran Lipid and Glucose Study.
43-Anthropometric predictors of incident type 2 diabetes mellitus in Iranian women.
44-Weight change and incident metabolic syndrome in Iranian men and women; a 3 year follow-up study.
45-Familial aggregation of the metabolic syndrome: Tehran Lipid and Glucose Study.
46-Impaired fasting glucose cutoff value of 5.6 mmol/l combined with other cardiovascular risk markers is a better predictor for incident Type 2 diabetes than the 6.1 mmol/l value: Tehran lipid and glucose study.
47- Triglyceride/HDL-cholesterol ratio is an independent predictor for coronary heart disease in a population of Iranian men.
48-Prevalence of metabolic syndrome by the Adult Treatment Panel III, International Diabetes Federation, and World Health Organization definitions and their association with coronary heart disease in an elderly Iranian population.
49- Prevention of non-communicable disease in a
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