AUTHOR=Moradi Soroush , Parsaei Amirhossein , Saeedi Moghaddam Sahar , Aryannejad Armin , Azadnajafabad Sina , Rezaei Negar , Mashinchi Baharnaz , Esfahani Zahra , Shobeiri Parnian , Rezaei Nazila , GBD 2019 Iran MRF Collaborators , Naghavi Mohsen , Larijani Bagher , Farzadfar Farshad , Moradi Soroush , Parsaei Amirhossein , Moghaddam Sahar Saeedi , Aryannejad Armin , Azadnajafabad Sina , Rezaei Negar , Mashinchi Baharnaz , Esfahani Zahra , Shobeiri Parnian , Rezaei Nazila , Aali Amirali , Abbasi-Kangevari Mohsen , Abbasi-Kangevari Zeinab , Abdollahi Shima , Absalan Abdorrahim , Afaghi Siamak , Ahmadi Ali , Moghadam Ahmadi Amir , Ahmadi Sepideh , Ajami Marjan , Akhlaghdoust Meisam , Alatab Sudabeh , Alimohamadi Yousef , Amir-Behghadami Mehrdad , Amiri Sohrab , Anvari Davood , Arabloo Jalal , Askari Elaheh , Seyyed Shamsadin Athari , Avan Abolfazl , Azari Samad , Babamohamadi Hassan , Baghcheghi Nayereh , Bagherieh Sara , Baradaran Prof Hamid Reza , Bashiri Azadeh , Dianatinasab Mostafa , Djalalinia Shirin , Dodangeh Milad , Dolatshahi Mahsa , Edalati Sareh , Farrokhpour Hossein , Fatehizadeh Ali , Ghadirian Fataneh , Ghashghaee Ahmad , Gholami Ali , Goleij Pouya , Hafezi-Nejad Nima , Hasani Hamidreza , Hassanipour Soheil , Heidari-Foroozan Mahsa , Hessami Kamran , Hosseini Kaveh , Hosseini Mohammad-Sala , Hosseini Seyed Kianoosh , Hoveidamanesh Soodabeh , Iravanpour Farideh , Irilouzadian Rana , Jamalpoor Zahra , Jamialahmadi Tannaz , Kabir Ali , Kaydi Neda , Kazemian Sina , Keykhaei Mohammad , Abdullatif Khafaie Morteza , Khanmohammadi Shaghayegh , Khateri Sorour , Kompani Farzad , Koohestani Hamid Reza , Mahjoub Prof Soleiman , Mahmoodpoor Prof Ata , Mahmoudimanesh Marzieh , Rad Prof Elaheh Malakan , Malekpour Mohammad-Reza , Malekzadeh Prof Reza , Mansournia Mohammad Ali , Marjani Abdoljalal , Mohammadi Esmaeil , Momtazmanesh Sara , Moradi Maryam , Moradi-Lakeh Maziar , Moradpour Farhad , Morovatdar Negar , Nejadghaderi Seyed Aria , Noori Maryam , Nouraei Prof Hasti , Nowroozi Ali , Okati-Aliabad Hassan , Pourshams Prof Akram , Rahimi Mehran , Rahmani Shayan , Rahmanian Vahid , Rashedi Sina , Rashidi Mohammad-Mahdi , Razeghian-Jahromi Iman , Rezaee Malihe , Sabzmakan Leila , Sadeghi Erfan , Sadeghi Prof Masoumeh , Sadeghian Saeid , Sahebkar Amirhossein , Salimzadeh Hamideh , Sargazi Saman , Sarrafzadegan Prof Nizal , Sepanlou Sadaf G , Shafeghat Melika , Shafie Mahan , Shahbandi Ataollah , Shahraki-Sanavi Fariba , Shams-Beyranvand Mehran , Sharifi-Razavi Athena , Shorofi Seyed Afshin , Tabatabaeizadeh Seyed-Amir , Tahamtan Alireza , Taheri Majid , Vahabi Seyed Mohammad , Vaziri Prof Siavash , Yazdanpanah Fereshteh , Zahir Mazyar , Zangiabadian Moein , Zare Iman , Zareshahrabadi Zahra , Naghavi Prof Mohsen , Larijani Prof Bagher , Farzadfar Prof Farshad TITLE=Metabolic risk factors attributed burden in Iran at national and subnational levels, 1990 to 2019 JOURNAL=Frontiers in Public Health VOLUME=11 YEAR=2023 URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1149719 DOI=10.3389/fpubh.2023.1149719 ISSN=2296-2565 ABSTRACT=Introduction

Metabolic risk factors (MRFs) predispose populations to a variety of chronic diseases with a huge burden globally. With the increasing burden of these risk factors in Iran, in this study, we aimed to report the estimated burden attributed to MRFs at national and subnational scales in Iran, from 1990 to 2019.

Methods

Based on the comparative risk assessment method of the Global Burden of Disease (GBD) Study 2019, data of deaths and disability-adjusted life years (DALYs) attributable to four top MRFs in Iran including high systolic blood pressure (SBP), high fasting plasma glucose (FPG), high body mass index (BMI), and high low-density lipoprotein (LDL) for the 1990–2019 period, were extracted. The socio-demographic index (SDI) was used to report the data based on the corresponding socio-economic stratifications. The results were reported in national and subnational 31 provinces of Iran to discover disparities regarding the attributable burden to MRFs. Furthermore, we reported the causes of diseases to which the attributable burden to MRFs was related.

Results

Overall, the age-standardized high LDL, high SBP, high BMI, and high FPG-attributed death rate changed by −45.1, −35.6, +2.8, and +19.9% from 1990 to 2019, respectively. High SBP was the leading risk factor regarding attributed age-standardized death rates reaching 157.8 (95% uncertainty interval: 135.3–179.1) and DALY rates reaching 2973.4 (2652.2–3280.2) per 100,000 person-years, in 2019. All rates increased with aging, and men had higher rates except for the +70 years age group. At the subnational level, provinces in the middle SDI quintile had the highest death and DALY rates regarding all four MRFs. Total deaths, DALYs, YLLs and YLDs number by the causes of diseases linked to MRFs increased over the study period. Cardiovascular diseases, diabetes mellitus, and kidney diseases were the main causes of burden of disease attributable to MRFs.

Conclusion

Herein, we found divergent patterns regarding the burden of MRFs as well as disparities in different regions, sex, and age groups for each risk factor and related causes. This could provide policymakers with a clearer vision toward more appropriate decision-making and resource allocation to prevent the burden of MRFs in Iran.