Clustering patterns of behavioral and metabolic risk factors for noncommunicable diseases in Iran: findings from a national STEPS survey.
Nearly half of Iranian adults belong to high-risk clusters for noncommunicable diseases, indicating a need for targeted prevention strategies.
Where it sits
this study against the rest of the slu-pp-332 (exercise mimetic) corpusSummary and findings
This study analyzed data from 16,618 adults aged ≥25 years in Iran's 2021 STEPS survey to identify patterns of co-occurring behavioral and metabolic risk factors for noncommunicable diseases (NCDs). Five distinct clusters were identified, including a healthy-low-risk cluster comprising 40.3% of participants and a hypertensive-diabetic cluster with 24.0% prevalence. The findings suggest significant co-occurrence of risk factors among the population.
Abstract
<h4>Background</h4>Noncommunicable diseases (NCDs) are the leading cause of mortality in Iran, driven by behavioral and metabolic risk factors that frequently co-occur.<h4>Objective</h4>To identify patterns of co-occurring behavioral and metabolic NCD risk factors among Iranian adults and characterize their demographic and socioeconomic correlates.<h4>Methods</h4>This cross-sectional study analyzed data from 16,618 adults aged ≥25 years who participated in Iran's 2021 nationally representative STEPS survey. Thirteen behavioral and metabolic variables, including physical activity, nutrition score, smoking frequency, alcohol intake, salt intake, body mass index, blood pressure, fasting plasma glucose, and lipid markers, were entered into a <i>K</i>-means clustering analysis. Clusters were characterized by their risk profiles and demographic/socioeconomic attributes. Multinomial logistic regression examined associations between cluster membership and sociodemographic factors.<h4>Results</h4>Five distinct behavioral-metabolic clusters emerged. The smokers-drinkers (SD) cluster (3.1%) comprised mostly older, less-educated men with high smoking and alcohol use. The healthy-low-risk (HLR) cluster (40.3%) showed favorable profiles and included younger, more educated individuals. The physically active (PA) cluster (6.6%) was characterized mainly by younger men with markedly high physical activity levels. The dyslipidemic (DLP) cluster (26.0%) exhibited high dyslipidemia and overweight prevalence, while the hypertensive-diabetic (HTD) cluster (24.0%) had the highest obesity, hypertension, and diabetes rates, common among older urban adults.<h4>Conclusion</h4>Behavioral and metabolic NCD risk factors in Iran formed five distinct co-occurrence patterns. Nearly half of adults belonged to metabolically high-risk clusters, highlighting the need for targeted prevention strategies that combine lifestyle interventions with screening and management of obesity, hypertension, diabetes, and dyslipidemia.
Background
Noncommunicable diseases (NCDs) are a major health concern in Iran, driven by various behavioral and metabolic risk factors. Previous studies have indicated that these risk factors often co-occur, contributing to the burden of NCDs. This study aims to identify distinct patterns of these co-occurring risk factors and their demographic and socioeconomic correlates among Iranian adults.
Methods
This cross-sectional study utilized data from 16,618 adults aged ≥25 years who participated in Iran's 2021 nationally representative STEPS survey. Thirteen behavioral and metabolic variables were analyzed using K-means clustering to identify distinct risk profiles. Multinomial logistic regression was employed to examine associations between cluster membership and sociodemographic factors.
Results
Five distinct behavioral-metabolic clusters were identified. The smokers-drinkers (SD) cluster comprised 3.1% of participants, the healthy-low-risk (HLR) cluster included 40.3%, the physically active (PA) cluster accounted for 6.6%, the dyslipidemic (DLP) cluster represented 26.0%, and the hypertensive-diabetic (HTD) cluster comprised 24.0%.
Interpretation
The identification of five distinct clusters of behavioral and metabolic risk factors adds to the understanding of NCDs in Iran. While the healthy-low-risk cluster is substantial, the presence of high-risk clusters indicates a significant public health challenge. The study's cross-sectional design and reliance on self-reported data may limit the ability to draw causal conclusions.
Key findings
- 3.1% of participants in the smokers-drinkers (SD) cluster.
- 40.3% of participants in the healthy-low-risk (HLR) cluster.
- 6.6% of participants in the physically active (PA) cluster.
- 26.0% of participants in the dyslipidemic (DLP) cluster.
- 24.0% of participants in the hypertensive-diabetic (HTD) cluster.
Limitations
- cross-sectional design limits causal inferences
- reliance on self-reported data may introduce bias