Cardiovascular risk factors in Iranian individuals with diabetes from 2007 to 2021: findings from STEPs surveys

Diabetes is a complex disease with rapidly increasing global prevalence. Patients with diabetes are more prone to cardiovascular events. Obesity, dyslipidemia, and hypertension (HTN) are key risk factors that contribute to cardiovascular complications in type 2 diabetes. To determine the trend of cardiometabolic risk factors over 15 years, this cross-sectional study used refined data from four consecutive WHO STEPwise approach to Non-communicable diseases Risk factors Surveillance (STEPs) in 2007, 2011, 2016, and 2021. Participants aged > 25 from Iranian provinces, stratified by sex, age, and urban/rural residence, were enrolled if fasting blood sugar was ≥ 126 mg/dl or on glucose-lowering medications. Those with incomplete data or without diabetes were excluded. Logistic regression models and a generalized linear model (GLM) with a Poisson distribution and a log link, along with robust standard errors, were used to assess the trend of risk factors. Diabetes prevalence rose significantly during these years (adjusted p-value < 0.0001), with an annual rise of 1.31% (0.87–1.76). Both abdominal obesity and obesity based on Body mass index (BMI) rose significantly over these 15 years, with annual rates of 0.27% (95%CI 0.02, 0.53; adjusted p-value = 0.031) and 1.37% (95%CI 0.8, 1.94; adjusted p-value < 0.0001), respectively. The prevalence of HTN and overweight, however, remained stable during this period, while dyslipidemia declined significantly at an annual rate of 0.26% (95%CI -0.41, -0.1; adjusted p-value = 0.001). These data help health policymakers implement strategies to control cardiometabolic risk factors, reduce healthcare burden, and prevent diabetes-related cardiovascular complications