Iranian Journal of

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Background: Diabetes mellitus is one of the chronic metabolic diseases with several organ damages that dearese life span. Prevalence of known diabetes appears to be increasing in most countries, presumably due to increasing the prevalence of risk factors such as obesity, lower physical activity and improved diagnosis. WHO expect the number of adults (20 years and older) with diabetes rises up to 300 millions in 2025. In view of the worldwide geographic differences in diabetes and lack of documented informations about prevalence of diabetes in Iran, we assigned this study.
Methods: The base of our study for assessment of prevalence of diabetes in Iran was results of ״Health and Disease Study in Iran, 1999״. We used epidemiologic model (DisMod) for estimating the incidence of diabetes in Iran. Results: The prevalence of diabetes in over 20 years of Iranian population in 2000, was 1.6 million or 4.67%. Also it is estimated up to 100000 persons have been affected by type II diabetes.
Conclusion: The true limitation of our study was limitations of documents about estimated of proportion of true prevalence to prevalence of known diabetes.

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Background: Non- alcoholic fatty liver disease (NAFLD) is a pathogenic factor of insulin resistance and type 2 diabetes. On the other hand, the circulating liver enzymes including Aspartate aminotransferase (AST), Alanin aminotranferase (ALT) and Gamma glutamyl transferase (GGT) are commonly elevated in asymptomatic patients with NAFLD.

Methods: As a nested case-control study, AST, ALT, GGT as well as classic diabetes risk factors, homeostatic model assessment of insulin resistance(HOMA- IR) and C-reactive protein (CRP) were measured in 133 non-diabetic subjects at baseline (68 cases and 65  controls). Conditional logistic regression was used to calculate the odds ratio (OR) of diabetes associated with different hepatic markers. We used factor analysis for clustering of classic diabetes risk factors.

Results: In Univariate analysis, both ALT and GGT were associated with diabetes with ORs of 3.07(1.21-7.79) and 2.91(1.29-6.53), respectively. After adjustment for CRP and insulin, ALT and GGT were still predictive of incident diabetes. When the model was further adjusted for anthropometric, blood pressure and metabolic factors resulted from factor analysis (full model), only ALT was independently associated with diabetes [OR=3.06 (1.01-9.26)]. No difference was found between the area under the receiver operating characteristic curves of the models with and without ALT (0.820 and 0.802 respectively, P=0.4)

Conclusion: ALT is associated with incident type 2 diabetes independent of classic risk factors. However, its addition to the classic risk factors does not improve the prediction of diabetes.

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Background: Although a positive association between type 2 diabetes and breast cancer has been reported, an association with gestational diabetes mellitus (GDM) is less clear. This study aimed to assess the relationship between the history of GDM and the incidence of BC a long term population based study.
Methods: To conduct this research, 4076 women aged 20-50 years who participated in the first phase of Tehran-Lipid-and-Glucose-Study, who had at-least one pregnancy were included. Each participants were asked about the history of GDM every 3 years. They was evaluated about the occurrence of breast cancer (BC). Cox-survival analysis was used to measure the Hazard-ratio (HR) for both groups with and without history of GDM
Results: The study population included 886 women with prior GDM and 3,909 women without history of GDM. The median duration of follow-up among women with and without the history of GDM were 12.12 and 11.62 years, respectively. The incidence of BC was 0.64 per 1,000 year-olds with confidence=interval of 95% (0.44-0.91). Among them, 4 cases were reported in women with GDM and 26 cases in women without GDM. (Incidence of 0.36 per 1000 person-years with confidence=interval 95% (0.11-0.99) in women with prior GDM and 0.73 per 1,000 person-years with confidence=interval 95% (0.49-1.1) in women without a history of GDM.
Conclusion: Our study showed that the history of GDM is not an independent risk factor for breast cancer.