Noncommunicable disease syndemic among the general population in Iran: a cross-sectional study

Zahra Torabi; Farshad Farzadfar; Negar Rezaei; Merrill Singer; Shahin Roshani; Maryam Tajvar; Elham Shakibazadeh

doi:10.1007/s40200-025-01615-7

Noncommunicable disease syndemic among the general population in Iran: a cross-sectional study

J Diabetes Metab Disord. 2025 Apr 10;24(1):102. doi: 10.1007/s40200-025-01615-7. eCollection 2025 Jun.

Authors

Zahra Torabi¹, Farshad Farzadfar², Negar Rezaei², Merrill Singer³, Shahin Roshani⁴, Maryam Tajvar⁵, Elham Shakibazadeh¹

Affiliations

¹ Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
² Noncommunicable Diseases Research Centre, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
³ Department of Anthropology, University of Connecticut, 354 Mansfield Road, Storrs, Connecticut, 06269 USA.
⁴ The Netherlands Cancer Institute (NKI), Amsterdam, Netherlands.
⁵ Department of Health Management, Policy and Economic, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Objectives: This study aims to investigate the status of the NCD syndemic among individuals over 25 in all provinces of Iran.

Methods: This study was based on a national survey. Using a systematic cluster random sampling framework, 26,707 participants were selected from all 31 Iranian provinces. The data were analyzed for descriptive statistics by gender and age, followed by principal component analysis and logistic regression, using R software for the statistical analysis.

Results: There was an interaction between diabetes mellitus and cardiovascular diseases, in their association with healthy life lost due to disability in the Iranian adult population. Additionally, there was a clustering of diabetes mellitus and cardiovascular diseases, partly due to the shared specific causes such as obesity, hypertension, shared baseline features, and poverty.

Conclusions: The syndemic analysis showed that social inequalities in diabetes and cardiovascular disease arise not only from exposure levels but also from varying vulnerabilities and disease outcomes. Iran's health policy should prioritize reducing these health inequalities.

Keywords: CVDs; Diabetes mellitus; NCDs; Noncommunicable diseases; Poverty; Syndemic.

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