Fereidoun Azizi

• Research Institute for Endocrine Sciences

Background The present study aimed to investigate the efficiency of the type 1 diabetes genetic risk score (T1D GRS) in distinguishing between patients with type 1 and type 2 diabetes in Iran, an underrepresented population in genomic research. Methods We included 13,318 participants in the Tehran-Cardiometabolic Genetic Study (TCGS) cohort, class...

Background The current study aims to investigate the association between dietary patterns and health-related quality of life (HRQoL) in a large Iranian adult population. Methods This cross-sectional study was conducted using the Tehran Lipid and Glucose Study (TLGS) data. Data from 5711 adults (53.0% female) collected by trained interviewers were...

Background and Objectives: Limited data are available regarding the association between the proportions of dietary fats, calculated in the form of fat quality indices, and cardiovascular disease (CVD). This study aimed to investigate the associations between dietary fat quality indices (FQI) and the risk of CVD among an Iranian adult population. Me...

Background The incorporation of electrocardiogram (ECG) abnormalities with other clinical indicators can strengthen the hypothesis regarding the improvement of diagnosis and the enhancement of screening accuracy for cardiovascular diseases. This study aimed to determine the risk of mortality from cardiovascular diseases (CVD) based on ECG abnormali...

This study assessed the effect of MetS status changes over 3 years on the long-term risk of CKD. The analysis included 5686 participants aged ≥ 20 years without pre-existing CKD (57.5% women), followed for a median of 15 years. Participants were classified into 4 groups according to their baseline MetS status and its changes: stable MetS-free, MetS...

Emerging evidence indicates that the health effects of saturated fatty acids (SFA) may differ depending on the food source from which they are derived. We aimed to determine the association between dairy-derived SFA and the risk of type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS). This research was carried out in the Tehran Lipid and G...

Background: Despite the reported connection between different combinations of the standard MetS criteria and chronic kidney diseases (CKD), most data raise significant concerns about its predictive usefulness in clinical settings beyond its components. Metabolic syndrome severity, expressed by the continuous metabolic syndrome severity score(cMetS-...

Background This study investigates the impact of the COVID-19 pandemic on perceived social support and health-related quality of life (HRQoL) in individuals with type 2 diabetes in the capital of Iran. Methods This longitudinal study, part of the Tehran Lipid and Glucose Study (TLGS), was conducted from 2017 to 2019. Among 389 eligible participant...

Background Genetic factors and an unfavorable intrauterine environment may contribute to the development of metabolic disorders in offspring later in life. The present study aims to investigate and compare the risks of pre-diabetes mellitus (pre-DM), type 2 diabetes mellitus (T2DM) and abnormal glucose tolerance in female and male offspring with ea...

Background Mineral deficiencies are significant public health concerns worldwide, contributing to the development and progression of non-communicable diseases (NCDs). We evaluated longitudinal adequacy of mineral intakes among Iranian adults. Methods Adult (aged ≥ 18) participants were included in the repeated cross-sectional analysis from 2006–20...

The relationship between mitochondrial DNA copy number (mtDNA-CN) and multiple sclerosis (MS) progression remains unclear, as previous observational studies have reported conflicting results. This study aimed to clarify the association between mtDNA-CN and MS progression using a bidirectional two-sample Mendelian randomization (MR) approach. MR ana...

To investigate, for the first time, the association between undiagnosed diabetes—using a single-sample confirmatory definition—and prevalent hypertension and cardiovascular diseases (CVD) in an Iranian national population. A few studies on this topic have been limited to Western populations. The study included 16328 adults aged ≥ 30 years. Diabetes...

This cohort study investigated the possible association between serum zinc (SZn) concentration and risk of progression to type 2 diabetes (T2D) in subjects with isolated impaired fasting glucose (iIFG). SZn concentrations were measured using flame atomic absorption spectrometry (FAAS) in 585 subjects with iIFG (mean age of 50.2 ± 13.9 y, and 52.1%...

Type 2 diabetes mellitus (T2DM) and thyroid dysfunction are some of the most prevalent endocrine disorders globally. Previous studies on the association and effect of thyroid hormones in patients with diabetes have yielded contradictory results. Therefore, this meta-analysis comprehensively examined the latest evidence regarding the bilateral assoc...

Aim We investigated the potential association between dietary mineral patterns and longitudinal change of glycemic status among individuals with prediabetes (Pre-DM). Methods This study included 1456 individuals with Pre-DM (mean age of 47.2 ± 12.8, and 52.5% men) who participated in the third (2006–2008) and fourth (2009–2011) examinations of the...

Background Evidence regarding the relationship between thyroid hormone levels within the normal range and the incidence of chronic kidney disease (CKD) in adults is scarce. This study aimed to identify the association between thyrotropin (TSH) and free thyroxine (FT4) levels with the incidence of CKD in a large cohort study over long-term follow-up...

The effect of the duration of medication with metformin and sulfonylurea (SUs) on microvascular complications based on the duration of type 2 diabetes (DM2) is unclear. The aim of this study was to investigate the association of medication time with metformin and SUs and microvascular complications in newly diagnosed DM2 patients. In this prospecti...

Both the clearance and secretion of prolactin are disrupted in chronic kidney disease (CKD). Evidence indicates that prolactin may play a role in cardiovascular (CV) disturbances. Considering the increased cardiovascular risk associated with CKD, this study investigates the relationship between prolactin levels, CKD, and the risk of CV events in bo...

Background and aim This cohort study investigated the potential association between dietary fat intakes and returning to normal glucose regulation (NGR) in different prediabetes (Pre-DM) phenotypes. Methods A total of 1587 Pre-DM subjects consisting of 60.2% isolated impaired fasting glucose (iIFG), 21% isolated impaired glucose tolerance (iIGT),...

This cohort study investigated the possible association between serum zinc (SZn) concentration and the risk of progression to type 2 diabetes (T2D) in subjects with isolated impaired glucose tolerance (iIGT). SZn was measured in 198 subjects with iIGT (mean age: 53.0 ± 14.4 years and 33.8% were men) at baseline (2009–2011), and they were followed f...

Background Spice and pepper are recognized as sources of antioxidants and anti-inflammatory compounds. This study investigated the association between spice or pepper intake and metabolic syndrome (MetS), related risk factors, or type 2 diabetes (T2D) incidences. Methods The qualified Tehran Lipid and Glucose Study (TLGS) participants were include...

Background Since foods are consumed in combinations that also interact with other lifestyle variables such as body mass index(BMI) and physical activity, it is difficult to separate the role of single foods or a lifestyle variable alone in predicting the risk of chronic diseases such as metabolic disorders. Therefore, a suitable way to examine the...

Background Despite the documented increased cardiovascular disease (CVD) risk in women with polycystic ovary syndrome (PCOS), no specific risk prediction tools are recommended for these patients. We aimed to assess the validity of the Framingham Risk Score (FRS) as a predictor of CVD risk in PCOS patients. Methods In a community-based prospective...

Background This cross-sectional study investigated the multi-stage and phenotype-specific association between urine-estimated salt intake and hypertension (HTN) in the Tehran Lipid and Glucose Study. Methods Adult participants (n = 1,782, mean age of 43.0 ± 13.7 years and 46.0% were men) were recruited (2015–2017) for 24-hour urine (24hU)-estimate...

Objective To provide an applied framework for assessing the genetic contribution to assortative mating (AM) using height as a model trait and disclose the trace of certain pieces of evidence of AM in the form of the shared environmental effects from long-term cohabitation on spouses’ anthropometric traits and lipid serum levels. Methods 2315 genot...

Background Studies have reported that the activity of alanine aminotransferase (ALT) is a key biomarker for screening liver cell damage, such as non-alcoholic fatty liver disease (NAFLD). Objectives Since individuals with metabolic syndrome (MetS) are at high risk for NAFLD, we aimed to determine gender-specific ALT thresholds for screening MetS i...

Objectives Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality globally, influenced by a complex interplay of risk factors including lipid disorders and insulin resistance (IR). The triglyceride-glucose (TyG) index and the triglyceride to high-density lipoprotein cholesterol (TG/HDL) ratio have emerged as potential indic...

Background Combination therapy with levothyroxine (L-T4) and slow-release T3 (SRT3) in the treatment of hypothyroidism results in a normal triiodothyronine/thyroxine (T3/T4) ratio above that of L-T4 monotherapy. No clinical study has been reported on SRT3 monotherapy for hypothyroidism. Methods This study was conducted in two parts. In the first p...

Background This study aimed to assess possible changes in mineral intake correlation between family pairs over time. Mineral intake was measured using a food frequency questionnaire. Methods FCOR command of the Statistical Analysis for Genetic Epidemiology software was used to determine the correlation coefficients of minerals in relative pairs. O...

Background and Objectives: The association between the consumption of dairy products and the risk of cardiovascular disease (CVD) is not well-known yet. Here, we aimed to determine the potential effects of total intake and subtypes of dairy products on the development of CVD in an Iranian adult population. Methods: Among adult participants of the t...

Background Previous studies reported that focusing on healthy lifestyle, especially high diet quality is necessary for preventing type 2 diabetes (T2D). This study investigated the association between the innovative index, the Global Diet Quality Score (GDQS), and the risk of Type 2 Diabetes incidence. Methods In this secondary analysis, we includ...

This study evaluated the effectiveness of the IraPEN program, an adapted version of the WHO Package of Essential Non-communicable Disease (PEN) intervention, in managing diabetes from September 2020 to September 2021 using the Input-Process-Output-Outcome framework. In this Cross-sectional/Ecological study, aggregated data was collected from IraPEN...

Background To evaluate a multi-setting lifestyle intervention’s effect on body mass index (BMI) across the entire spectrum in a middle-income adult population over 15 years. Methods This pragmatic interventional study included 5153 adults (≥20 years) from a middle-income community, followed for over 15 years with five follow-ups. A multi-setting i...

Background Although endogenous estrogen exposure, influenced by reproductive factors (RFs), is negatively associated with fracture risk, there is limited and conflicting information on the association between these factors and the incidence of fractures. This study aimed to evaluate the association between RFs and fracture incidence (FXI) separatel...

Background: Metabolic Syndrome (MetS) is a prevalent condition associated with an increased risk of cardiovascular disease (CVD) and CVD mortality. Due to the limited clinical applicability of MetS, the standardized continuous metabolic syndrome severity score (cMetS-S) has the potential to provide continuous assessment of metabolic risk. Objective...

This cohort study investigated the possible association of dietary nitrate (NO3)/nitrite (NO2) intake and risk of progression to type 2 diabetes (T2D) across different phenotypes of prediabetes (Pre-DM). A total of 1586 adults diagnosed with Pre-DM [i.e., 60.2% isolated impaired fasting glucose (iIFG), 21% isolated impaired glucose tolerance (iIGT)...

Background Type 2 diabetes mellitus (T2DM) poses a significant public health challenge, contributing to considerable morbidity and mortality worldwide, which necessitates urgent preventive measures. Thyroid disorders, prevalent in many individuals, are intricately linked to metabolic health, yet studies on their relationship with T2DM yield inconsi...

Objective To assess associations between dietary fat quality indices (FQI) and risk of pre-diabetes and type 2 diabetes mellitus (T2DM) among Iranian adults. Design Daily intakes of fatty acids were estimated using a validated food frequency questionnaire with 168 food item. Adjusted hazard Ratios (HRs) and 95% confidence intervals (CIs) of pre-di...

Background Obesity is associated with the development of polycystic ovarian syndrome (PCOS), a complex endocrine disorder. However, the correlation between body composition and PCOS in women has not been thoroughly investigated. This study aimed to examine body composition using bioelectrical impedance analysis (BIA) in women with and without PCOS...

Purpose The current study aimed to investigate the associations between metabolic syndrome (MetS) with health-related quality of life (HRQoL) using multilevel analysis among the Iranian adult population. Methods This cross-sectional study was conducted in the framework of the Tehran Lipid and Glucose Study (TLGS). Participants were 6113 participan...

Purpose Metabolic syndrome (MetS) is the primary cardiovascular risk factor, making it a global issue. Our objective was to assess the association between the age at menarche (AAM) and MetS and its components in different generations of women. Methods In this cross‐sectional study, 5500 eligible women aged ≥ 20 who participated in the Tehran lipid...

Aim We assessed the impact of a 3-year change-percent in adiposity measures on regression and pre-diabetes (Pre-DM) progression among Iranian adults. Methods Three-year change-percent in body weight (BW), body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and visceral adiposity index (VAI) were calculated for 1458 Pre-DM su...

Body mass index (BMI) is a well-known risk factor for type 2 diabetes mellitus (T2DM). We aimed to identify BMI trajectory patterns and evaluate their association with T2DM during 18 years of follow-up. We included 6026 participants aged 20 to 65 from the prospective population-based Tehran Lipid and Glucose Study (TLGS). The BMI trajectory pattern...

This cross-sectional study investigated the associations between urinary sodium (UNa) to potassium (UK) ratio, different phenotypes of elevated blood pressure (BP), and microalbuminuria (MAU) in a cohort of the Tehran Lipid and Glucose Study (TLGS). Adult participants (n = 1782, mean age of 43.0 ± 13.7 years and 46.0% were men) were recruited (2015...

This study aimed to examine the association between blood pressure (BP) with health-related quality of life (HRQoL) and emotional states, considering the disease awareness and commitment to treatment among the Iranian adult population. This cross-sectional study uses the data of 7257 and 2449 individuals aged ≥ 20 who had completed data on HRQoL an...

Background Diabetes can be detected at the primary health-care level, and effective treatments lower the risk of complications. There are insufficient data on the coverage of treatment for diabetes and how it has changed. We estimated trends from 1990 to 2022 in diabetes prevalence and treatment for 200 countries and territories. Methods We used da...

Background: The impact of thyroid dysfunction (TD) on the female reproductive system has been extensively documented. While there is evidence suggesting that alteration in female reproductive status may affect thyroid function, conflicting results have prevented definitive conclusions. This study aimed to investigate the associations of parity, spo...

Background/Aim Familial resemblance in dietary patterns has been a subject of interest, with both genetic and environmental factors playing crucial roles. This study aims to investigate trends in macronutrient intake correlations over a 9-year period among different familial pairs, including parent-offspring, siblings, and spouses, using data from...

Aims Endometriosis (EM) and metabolic disorders are frequent health problems among reproductive‐aged women worldwide. Cardio‐metabolic risk profile of women with EM is not well understood. We aimed to investigate the cardio‐metabolic risk profile of Iranian reproductive‐aged women with EM. Methods This study included 976 female participants aged 2...

Background No study has investigated the association between ultra-processed food (UPF) and pre-diabetes development. Furthermore, prior investigations on the association between UPF and the risk of type 2 diabetes (T2D) were primarily conducted in Europe and America, and studies in other regions are lacking. We investigated the association between...

Aims To assess the risk of difference between 2 h post‐load plasma glucose (2 h‐PG) and fasting plasma glucose (FPG) on incident prediabetes/type 2 diabetes (T2DM) among normoglycemic individuals. Methods Among 4,971 individuals aged ≥20 years, the associations of the difference between 2 h‐PG and FPG with outcomes were examined using multivariabl...

Introduction Obesity is a known risk factor for chronic kidney disease (CKD), but the impact of obesity severity and duration on CKD incidence is unclear. Methods Cumulative Excess Weight (CEW) and Cumulative Excess Waist Circumference (CEWC) scores were calculated, which represent the accumulation of deviations from expected body mass index and w...

This study aims to assess the effect of familial structures on the still-missing heritability estimate and prediction accuracy of Type 2 Diabetes (T2D) using pedigree estimated risk values (ERV) and genomic ERV. We used 11,818 individuals (T2D cases: 2,210) with genotype (649,932 SNPs) and pedigree information from the ongoing periodic cohort study...

Aims The impact of life-course different adiposity indices on diabetes mellitus (DM) is poorly understood. We aimed to do trajectory analysis with repeated measurements of adiposity indices in the development of DM among women across the lifespan. Methods This study prospectively investigated the 1,681 population of Tehran Lipid and Glucose Study....

Objectives This study aimed to investigate the association between age-specific and sex-specific continuous metabolic syndrome severity score (cMetS-S) and the risk of developing type 2 diabetes mellitus (T2DM). Additionally, the study aimed to assess the added value of cMetS-S in predicting T2DM compared with traditional MetS criteria. Design The...

Background The association between baseline triglyceride glucose index (TyG index) and incident non-communicable diseases, mainly in Asian populations, has been reported. In the current study, we aimed to evaluate the association between index-year, average, and visit-to-visit variability (VVV) of the TyG index with incident type 2 diabetes mellitu...

Background Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hyper...

Background The association between macronutrient consumption and the risk of type 2 diabetes (T2D) remains equivocal. Here, we investigated whether the quantity and quality of macronutrient intake are associated with T2D incidence in a West Asian population. Methods T2D-free adults (n = 2457, mean age 38.5 ± 13.6 years, 54.2% women) who participat...

The incidence of hypertension (HTN) and consumption of ultra-processed foods are increasing worldwide.

Maturity-onset diabetes of the young (MODY) is an uncommon monogenic type of diabetes mellitus. Detecting genetic variants for MODY is a necessity for precise diagnosis and treatment. The majority of MODY genetic predisposition has been documented in European populations and a lack of information is present in Iranians which leads to misdiagnosis a...

Background: Various food quality indicators have been proposed as tools for predicting metabolic syndrome (MetS). This study investigated the association between global diet quality score (GDQS) and the risks of developing MetS and its components. Methods: In this secondary analysis, we included elective adult participants (n=4,548) from the Teh...

Purpose There are contradictions in the association between dietary variety and metabolic syndrome (MetS). The concept of dietary variety should be merged with other dietary recommendations including diet quality and proportion. We aimed to investigate the association of the healthy food diversity index with MetS and its components in Iranian adult...

Background There are emerging controversies regarding the priority of T4 + T3 combination therapy over standard care with LT4 monotherapy in the management of hypothyroid subjects. Combination therapy with a slow-release form of liothyronine (SRT3) and levothyroxine may restore T3 concentrations and provide better outcomes, especially in individual...

Background This prospective cohort study aimed to investigate the association between ultra-processed food (UPF) and the risk of metabolic syndrome (MetS), as well as to assess whether fruit and vegetable intake and weight change modify this association. Methods We included 1915 healthy participants who participated in the Tehran Lipid and Glucose...

Background In this prospective study, we aimed to examine the association between ultra-processed foods and health-related quality of life (HRQoL) and to evaluate the effect of lifestyle and socioeconomic factors on this association. Methods This study included 1766 adults (aged 18 to 78, 54.3% women), who took part in the Tehran Lipid and Glucose...

Objective The aim of the present study was to examine and quantify whether the association between preterm birth (PTB) and pre‐pregnancy body mass index (BMI) is mediated by gestational weight gain (GWG). Methods This is a secondary analysis of a large randomized community non‐inferiority trial using a cohort design. The data of 26 101 pregnant wo...

Introduction: This study aimed to determine the association between the quality and quantity of dietary carbohydrate (CHO) with the risk of pre-diabetes (pre-DM) progression to type 2 diabetes (T2D) and the chance of returning to normal glycemia. Materials and Methods: Dietary CHO quantity (total CHO and dietary fiber) and quality (glycemic index,...

Background Understanding the relationship of thyroid hormones with the development of chronic kidney disease (CKD) has important clinical implications for managing patients with both thyroid and kidney dysfunction. In this review, our purpose was to provide a thorough comprehension of the interplay between thyroid hormones, thyroid dysfunctions, an...

Type 2 diabetes (T2D) is known as a major public health problem with a noticeable adverse impact on quality of life and health expenditures worldwide. Despite using routine multiple pharmacological and nonpharmacological interventions, including diet therapy and increasing physical activity, controlling this chronic disease remains a challenging is...

Type 2 diabetes (T2D) is known as a major public health problem with a noticeable adverse impact on quality of life and health expenditures worldwide. Despite using routine multiple pharmacological and nonpharmacological interventions, including diet therapy and increasing physical activity, controlling this chronic disease remains a challenging is...

Antithyroid drugs (ATD) are the treatment of choice for the majority of patients with Graves’ hyperthyroidism worldwide. However, relapse of hyperthyroidism after withdrawal of arbitrarily chosen conventional 12 to 18 months of therapy is very common. In the last 2 decades, many studies have shown that treatment with long-term ATD (LT-ATD) is effec...

The global population is undergoing rapid aging, and the consequential decline in skeletal muscle mass with age presents substantial health risks, underscoring the importance of precise identification and gender-specific measurements. This study aimed to investigate the prevalence of low muscle mass among individuals aged > 60 years and identifying...

Background: This study was conducted to assess the prospective association between dietary polyphenols intakes and risk of metabolic syndrome (MetS) and its components. Methods: Participants in this study (n=4559) were selected from among the adults of the Tehran Lipid and Glucose Study (TLGS) with an average follow-up of 5.9+2.5 years. Biochemi...

Background Limited studies have investigated the relationship between Anti-Müllerian hormone (AMH) and metabolic syndrome (MetS), yielding inconclusive results. This study aimed to examine the relationship between AMH levels and MetS and its components in women from a general population. Methods This prospective study recruited 769 women. Generali...

Background Despite the high burden of obesity and Type 2 diabetes (T2DM) in the Middle East/West Asia region, the effect of weight change on the development of T2DM is poorly addressed. Therefore, we aimed to assess the impact of 3-year body weight change on incident of T2DM over 3-, 6-, and 9-year periods among Iranian adults. Methods A total of...

Background We aimed to assess the relationship between Metabolic Score for Insulin Resistance (METS-IR) and the incidence of coronary heart disease (CHD), stroke, mortality, diabetes, hypertension, and chronic kidney disease (CKD) in a population from the Middle East and North Africa (MENA) region. Method Individuals aged ≥ 20 years were enrolled....

Background The role of endogenous estrogen exposure (EEE) in shaping body composition and its implications for cardiometabolic health remain understudied despite its potential significance. This cross-sectional study aimed to investigate the association between EEE and body composition indices among postmenopausal women. Methods Data were obtained...

Background For the first time, the present study investigated smoking trajectory and cardiometabolic profile from adolescence to young adulthood in a middle‐income developing country facing a high prevalence of smoking and cardiovascular disease‐related outcomes. Methods and Results Data on 1082 adolescents (12–18 years of age) who participated in...