Multinational Monitoring Of Trends And Determinants In Cardiovascular Disease Research Articles

IL-6 as a Mediator of the Association Between Traditional Risk Factors and Future Myocardial Infarction: A Nested Case-Control Study.

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Changes in physical activity and mortality risk among an adult Lithuanian urban population: results from a cohort study

ObjectivesThe purpose of this study was to investigate changes in physical activity and the association of these changes with the risk of all-cause mortality and mortality from cardiovascular disease (CVD) among an adult and elderly Lithuanian urban population. Study designProspective cohort study. MethodsData from four surveys are presented. In total, there were 2416 participants (1071 men and 1345 women) who took part in one of the initial three surveys in the framework of the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study since 1986 and also in the follow-up survey in 2006 (with follow-up over 15 years). Study participants were followed-up for mortality events from 2006 until 31 December 2017. The mean duration of the follow-up for endpoints period was 10.55 (standard deviation 2.33) years. ResultsOver 15 years of follow-up, 50.9% of men and 56.7% of women were physically active at initial and follow-up surveys, and approximately 10.0% of respondents were physically inactive. Over this period, 22.8% of men and 24.8% of women increased their physical activity level, and 14.1% of men and 10.1% of women decreased their physical activity level. The findings from the Cox proportional hazards regression multivariable analysis showed that a decrease in physical activity level during the follow-up period was related to a higher risk for all-cause mortality and mortality from CVD risk in women (hazard ratio [HR] = 1.82, P = 0.039; and HR = 5.40, P = 0.014, respectively). In men, a clear association of physical inactivity was ascertained only to all-cause mortality risk and only for non-smokers (HR = 2.07, P = 0.013). ConclusionsA decrease in physical activity levels in women is a strong predictor for all-cause mortality risk and mortality from CVD risk. Physical inactivity in male non-smokers is a strong predictor for all-cause mortality risk.

The role of single-nucleotide polymorphism rs10824026 of the SYNPO2L gene in the development of atrial fibrillation in a study in the East-Siberian population

Background. Atrial fibrillation (AF) is the most common type of heart rhythm disturbance, leading to the development of lifethreatening conditions, such as cardio embolism, heart failure, and even sudden cardiac death. In recent years, the genetic aspects of AF have been actively discussed. The largest number of genetic predictors of AF was identified after a full genome-wide association studies (GWAS). Given that so far no studies of the association of rs10824026 polymorphism of chromosome 10q22 with the development of AF have been conducted in the Russian population, we conducted this clinical study. Aim. Checking the associations of the development of AF with the single-nucleotide polymorphism rs10824026 of the SYNPO2L gene in the East-Siberian population. Materials and methods. The study design was formed in accordance with the National Standard of the Russian Federation Good Clinical Practice, GOST P 52379-2005. The study uses design - “case-control”. The main group of patients - patients with known cardiac arrhythmias by the type of AF (n=106, average age 57.0±9 years, men 49.4%, women 50.6%), the group was formed using the criteria of the World Health Organization and the European Society of cardiologists. The control group (n=105, average age 57.0±9 years, men - 50.0%, women - 50.0%) was selected by age and gender from the DNA bank of international studies MONICA (Multinational MONItoring of trends and determinants in cardiovascular disease) under a joint agreement with the Research Institute of Therapy and preventive medicine - Novosibirsk. DNA was isolated by phenol-chloroform extraction. Among other things, among the research methods, routine laboratory methods were used; instrumental data; and invasive tactics such as CAG. Results. As a result of clinical genetic testing, it was found that the frequency of G/G polymorphism of the SYNPO2L gene in patients with AF shows a statistically significant difference.

PERSIAN REGISTRY OF CARDIOVASCULAR DISEASE (PROVE)

AbstractIntroduction: The Persian Registry Of cardioVascular diseasE (PROVE) aimed to study the demographic, clinical, diagnosis and treatment of patients with cardiovascular disease (CVD) and to follow them for 1 to 3 years, looking for short- and long-term outcomes. PROVE started in Isfahan in 2014 to test the feasibility of its implementation for later national dissemination. Therefore, we aimed to explain its design, methodology, development, validity of protocols and questionnaires of each CVD and its quality control (QC) design Methods: PROVE feasibility study is an observational (descriptive and analytical) open-label registry that collects patient’s data in hospitals or at population level, and follows them for between 1 to 3 years. Patients with acute coronary syndrome (ACS), ST Elevation Myocardial Infarction (STEMI), stroke, atrial fibrillation (AF), heart failure(HF); congenital heart disease (CHD), percutaneous coronary intervention (PCI) and recently, chronic ischemic cardiovascular disease (CICD) were enrolled. Four types of registered CVD (AF, STEMI, HF, CICD) had joined the European observational Research Programme (EORP). ACS and stroke registry started back in 1999 in the surveillance unit of Isfahan Cardiovascular Research Institute (ICRI) using the WHO MONICA (Multinational MONItoring of trends and determinants in CArdiovascular disease) protocol. Physicians and nurses who worked in each registry, received multiple training sessions based on the design of the registry. The development and validity of questionnaires, protocols, data collection, entry and management, and its analysis are supervised by a well-established QC protocol. Results: PROVE subtypes followed different approaches. ACS, STEMI, stroke, HF and CICD are hospital based while AF and CHD are population based. The validity of questionnaires was performed by a QC committee before starting registry. More than 900 questionnaires of HF and 800 of STEMI, 350 of AF, 800 of stroke, more than 1000 of CHD and PCI and 9 of CICD were registered and all its data were managed by mid-September 2016. Using the WHO MONICA method for ACS and stroke since the year 1999, there were more than 150,000 and 37,000 patients registered and followed respectively. The follow up frequency, duration and method was different according to type of disease registry. The case report forms (CRFs) of AF, STEMI, HF, and CICD were sent to the EORP site. Conclusion: PROVE implementation is feasible and can be considered as a valuable source of valid data to improving the management, treatment, prevention and control of patients with CVD. The data can be later used by policy makers and for future research

The Impact of Smoking Cessation Training-Counseling Programs on Success of Quitting Smoking in Patients with Acute Coronary Syndrome

Background: The smokers who use supportive programs have a greater chance to quit smoking. Smoking cessation recommendation is one of the most important prevention and treatment methods mentioned in care guidelines provided for patients with acute coronary syndrome. Aim: The main objective of this study is to determine the effects of training-counseling programs on smoking cessation in patients with acute coronary syndrome. Method: In this randomized controlled clinical trial, 51 patients with acute coronary syndrome in Ghaem and Imam Reza hospitals in Mashhad, 2015, after filling the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) questionnaire, were categorized into two groups. Intervention group received smoking cessation training-counseling program and control group received some advices/recommendations to quit smoking. After a three-month telephone follow-up, smoking cessation standard questionnaire was filled for all patients. The data were analyzed using SPSS v11.5 and Chi-square test. Results: The age of study participants was 52.6± 7.9 and 56.2±12.3 for intervention and control group, respectively. According to Chi-square test, a significant difference was observed between intervention and control groups in first through fifth stages after the intervention in terms of succeed to quit smoking (p<0/05), but this difference wasn’t significant in sixth stage after intervention (p=0/06). Implications for Practice: According to the findings of the study and given that the nurses are in the frontline of treatment process and also because they spend more time with patients and have a major impact on them, it is suggested to take advantage of the nurses to improve smoking cessation training-counseling programs regarding patients with acute coronary syndrome.

Genetic polymorphisms in asthmatic patients living at Krasnoyarsk

The aim of the study was to evaluate a role of transforming growth factor"β1 (TGF"β1) gene rs1800470 single nucleotide polymorphisms (SNPs), cytotoxic T"lymphocyte"associated protein 4 (CTLA4) gene rs231775 SNPs and hedgehog"interacting protein (HHIP) gene rs1828591 SNP for predisposition to bronchial asthma (BA) in Krasnoyarsk residents.Methods. The study involved 100 asthma patients and 338 control subjects. The control group included a representative population sample of Siberian urban residents without respiratory diseases who had participated in the WHO MONICA (Multinational Monitoring of Trends and Determinants in Cardiovascular Disease) and the HAPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe) projects.Results. There was a significant difference in genotype and allele frequency distribution of the TGFβ gene in patients with non"allergic BA vs controls. Therefore, A allele carriers with heterozygous genotype AG and homozygous genotype AA of rs1800470 polymorphism of the TGF"β1 gene were at high risk of non"allergic BA. We also found an increase in the GG genotype frequency in BA group compared to the control group. The GG genotype of CTLA4 gene rs231775 polymorphism was associated with high risk of allergic BA (ОR = 2.036; 95% CI = 1.16–3.58; р = 0.012). Genotype and allele frequency distribution of HHIP gene rs1828591 polymorphism did not differ significantly between BA patients and the control group.Conclusion. An association was revealed between BA, TGF"β1 gene rs1800470 SNPs and CTLA4 gene rs231775 SNPs. An association between BA and HHIP gene rs1828591 SNPs was not found.

WHO MONICA Project and its Connections to the North Karelia Project.

The World Health Organization's MONICA (Multinational Monitoring of Trends and Determinants in Cardiovascular Disease) Project was established after the increase in mortality from coronary heart disease had turned to a decline in some countries. Its objective was to measure the trends in cardiovascular mortality and coronary heart disease and cerebrovascular disease morbidity, and to assess the extent to which these trends were related to changes in known risk factors and health care measured at the same time in defined populations in different countries. Thirty-one centers in 21 countries carried out the monitoring over a period of 10 years in the 1980s and 1990s. The project provided information on disease rates, risk factors, and treatment for the first time in most of the study populations. The results answered some of the initial questions and opened new questions on the complexity of the associations between disease trends and their determinants. MONICA had a major impact in training cardiovascular epidemiologists and in creating measurement standards for international use.

Long-term subarachnoid haemorrhage survivors still die due to cerebrovascular causes.

Subarachnoid haemorrhage (SAH) is associated with sympathetic nervous activation and inflammation. SAH could therefore theoretically be a risk factor for development of cardiovascular disease. The aim of this study was to investigate whether long-term (≥1year) SAH survivors had an increased risk of death due to cardiovascular causes. SAH patients ≥18years treated at Umeå University Hospital between 1986 and 2006 were eligible for inclusion. Deceased patients were identified in the Swedish population register. Death certificates from long-term SAH survivors and causes of death in the general population were obtained from the National Board of Health and Welfare, Sweden. The prevalence of comorbidities at the time of SAH was compared with the distribution of cardiovascular risk factors in the northern Sweden MONICA (Multinational Monitoring of Trends and Determinants in Cardiovascular Disease) health survey. Analyses were stratified for age and sex. In the SAH patients, the median year of SAH was 1992 and the median year of death was 2001. The MONICA survey in 1994 and the distribution of deaths in the general population in 2001 were used for comparison. Long-term SAH survivors had, compared to the general population, a significantly increased risk for death due to cerebrovascular disease (P<0.0001), but not for death due to cardiovascular disease. Hypertension was more common in SAH patients compared to survey participants (P<0.01). Cerebrovascular causes of death were significantly more common in long-term survivors after SAH compared to the general population.

Work situation and self-perceived economic situation as predictors of change in burnout--a prospective general population-based cohort study.

BackgroundSick leave rates due to mental and behavioural disorders have increased in Sweden during the last decades. The aim of this prospective study was to investigate changes in the level of burnout in a working subset of the general population and to identify how such changes relate to changes in work situation and self-perceived economic situation.MethodsA cohort of 1000 persons from a subset of the 2004 northern Sweden MONICA (Multinational Monitoring of Trends and Determinants in Cardiovascular Disease) general population survey was followed over a five-year period (2004–2009). In total, 623 persons (323 women and 300 men) were included in the analysis. Burnout levels were measured at baseline and follow-up using the Shirom Melamed Burnout Questionnaire. Risk factors were assessed at both measuring points.ResultsIn the whole study cohort, a small (−0.15) but statistically significant reduction in burnout level was found. No differences in change of burnout were found between men and women. Constant strain at work, an increased risk of unemployment, and a perceived worsening of economic situation during the study time period were related to an increased burnout level. An accumulation of these risk factors was associated with increased burnout level.ConclusionsRisk factors in work situation and self-perceived economy are related to changes in burnout level, and special attention should be directed towards persons exposed to multiple risk factors.

Update of the German Diabetes Risk Score and external validation in the German MONICA/KORA study

AimsSeveral published diabetes prediction models include information about family history of diabetes. The aim of this study was to extend the previously developed German Diabetes Risk Score (GDRS) with family history of diabetes and to validate the updated GDRS in the Multinational MONItoring of trends and determinants in CArdiovascular Diseases (MONICA)/German Cooperative Health Research in the Region of Augsburg (KORA) study. MethodsWe used data from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study for extending the GDRS, including 21,846 participants. Within 5 years of follow-up 492 participants developed diabetes. The definition of family history included information about the father, the mother and/or sibling/s. Model extension was evaluated by discrimination and reclassification. We updated the calculation of the score and absolute risks. External validation was performed in the MONICA/KORA study comprising 11,940 participants with 315 incident cases after 5 years of follow-up. ResultsThe basic ROC-AUC of 0.856 (95%-CI: 0.842–0.870) was improved by 0.007 (0.003–0.011) when parent and sibling history was included in the GDRS. The net reclassification improvement was 0.110 (0.072–0.149), respectively. For the updated score we demonstrated good calibration across all tenths of risk. In MONICA/KORA, the ROC-AUC was 0.837 (0.819–0.855); regarding calibration we saw slight overestimation of absolute risks. ConclusionsInclusion of the number of diabetes-affected parents and sibling history improved the prediction of type 2 diabetes. Therefore, we updated the GDRS algorithm accordingly. Validation in another German cohort study showed good discrimination and acceptable calibration for the vast majority of individuals.

Men benefit more from midlife leisure-time physical activity than women regarding the development of late-life disability — Results of the KORA-Age study

ObjectiveEncouraging physical activity is an important public health measure to reduce disability prevalence in the aged. The aims of this study were to determine the association between midlife physical activity and late-life disability and to investigate gender-specific differences. MethodThis data originates from the KORA-Age cohort, a follow-up in 2008 of the MONICA (Multinational Monitoring of Trends and Determinants in Cardiovascular Diseases)/KORA (Cooperative Health Research in the Region of Augsburg) S1–S4 surveys (1984–2001) situated in Augsburg, a city in Southern Germany. We applied a multivariable hurdle model to investigate the association of physical activity and disability. ResultsWe analysed 3333 persons with a mean follow-up of 18±5.5years. Using hurdle models, moderate activity and high activity had a protective effect on the occurrence of disability (OR (odds ratio)=0.80 and 0.73), but not on severity (i.e. number of limitations). We observed a strong gender-specific difference in this association, with men benefitting more from exercise. ConclusionElevated physical activity reduces the risk of becoming disabled and postpones the onset of disability by several years, but we could not show an effect on the severity of disability. In addition, men seem to benefit more from leisure-time physical activity than women.

The low prevalence of smoking in the Northern Sweden MONICA study, 2009

The purpose of this study was to describe tobacco use in the 2009 Northern Sweden cohort of the World Health Organization Multinational Monitoring of Trends and Determinants in Cardiovascular Diseases (MONICA) study. Subjects (N = 1698) were randomly selected from population registers, stratified for age (25-74 years old) and gender, in the two northernmost Swedish counties of Norrbotten and Västerbotten. Responses from tobacco-related questions were used to develop three mutually exclusive categories of snus use: past, current, or never use; and three comparable categories of smoking that were consistent with previous studies. Among men, the prevalence of smoking (9%) and dual use (2%) remain unchanged from 2004, although the prevalence of snus use declined from 27% in 2004 to 24% in 2009. Among women, the prevalence of all forms of tobacco use declined between 2004 and 2009; smoking dropped from 16% to 11%, dual use from 2% to less than 1%, and snus use from 9% to 8%. Although overall prevalence of tobacco use was similar for younger versus older men and younger versus older women, there were notable differences in specific snus and smoking rates. This study confirms that use of snus was a significant factor in the low prevalence of smoking, especially among younger men and women in Northern Sweden. Furthermore, it documents that tobacco harm reduction is entirely compatible with a population-level decline in overall tobacco use.

All-cause and cardiovascular mortality risk estimation using different definitions of metabolic syndrome in Lithuanian urban population

ObjectiveThe objective of the study was to assess mortality risk in the subjects with diagnosed metabolic syndrome (MS) using National Cholesterol Educational Program (NCEP-ATPIII), American Heart Association and National Heart Lung and Blood Institute (AHA/NHLBI) International Diabetes Federation (IDF) and Joint Interim Societies (JIS) definitions. MethodsTwo random samples aged 35–64years were examined in 1992–2002 in the framework within the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study (N=2455). The follow-up was carried out in terms of the end points reached from the baseline health examinations until December 31, 2009. ResultsCox regressions demonstrated that MS defined by IDF and JIS definitions remained the only significant determinants for all-cause mortality (RR=1.48 and RR=1.41; p<0.05) and cardiovascular disease (CVD) mortality in men (RR=1.81 and RR=1.66; p<0.05). In men (without previous CVD) the NCEP-ATPIII definition had increased mortality risk from CVD (RR=1.98; p=0.012), than in men with identified MS by the IDF and the new JIS definition. In women the MS was not associated with risk of mortality from CVD. ConclusionThe MS definitions according to the IDF and JIS criteria appear to be a slightly better predictor of all-cause mortality and mortality from CVD; MS according to the NCEP-ATPIII criteria appears to be a better predictor of mortality from CVD in men.

Patients with diabetes are not more likely to have atypical symptoms when seeking care of a first myocardial infarction. An analysis of 4028 patients in the Northern Sweden MONICA Study

To describe symptoms of a first myocardial infarction in men and women with and without diabetes. We conducted a population-based study of 4028 people aged 25-74 years, with first myocardial infarction registered in the Northern Sweden Multinational MONItoring of trends and determinants in CArdiovascular disease (MONICA) myocardial infarction registry between 2000 and 2006. Symptoms were classified as typical or atypical according to the World Health Organization MONICA manual. Among patients with diabetes, 90.1% reported typical symptoms of myocardial infarction; the corresponding proportion among patients without diabetes was 91.5%. In the diabetes group, 88.8% of women and 90.8% of men had typical symptoms of myocardial infarction. No differences were found in symptoms of myocardial infarction between women with and without diabetes or between men with and without diabetes. Atypical symptoms were more prevalent in the older age groups (> 65 years) than in the younger age groups (< 65 years). The increases were approximately equal among men and women, with and without diabetes. Diabetes was not an independent predictor for having atypical symptoms of myocardial infarction. Typical symptoms of myocardial infarction were equally prevalent in patients with and without diabetes and there were no sex differences in symptoms among persons with diabetes. Diabetes was not a predictor of atypical symptoms.

The effect of revascularization procedures on myocardial infarction incidence rates and time trends: The MONICA-Brianza and CAMUNI MI registries in Northern Italy

PurposeClinical guidelines recommend early reperfusion treatment in myocardial infarction (MI) patients to reduce the cardiac damage. Epidemiologic definitions of MI are often based on the evolution of the cardiac lesion. We aim to study the effect of treatment on the estimates of rates and 20-year time trends of MI. MethodsA Multinational Monitoring of trends and determinants in Cardiovascular disease (MONICA) register was active between 1985 and 2004 to survey 35- to 64-year-old residents in Brianza, Northern Italy. To the well-established MONICA definite MI, we added the MONICA possible nonfatal MI receiving either myocardial revascularization or thrombolysis within 24 hours from onset. The average annual relative changes in incidence rate and 28-day case fatality percentage were estimated from log-linear models. ResultsIn our population, characterized by a monotonic decrease in coronary heart disease (CHD) mortality rates, the incident rate for the standard MONICA definite MI decreased yearly by 3% in both gender groups. The addition of selected revascularizations halved the downward trends in incidence rate in men and women; conversely, the decline in 28-day case fatality became steeper. ConclusionsFrom an epidemiologic perspective, the increasing proportion of acute events efficaciously treated with revascularization therapy affects the estimate and the interpretation of time trends in MI incidence and CHD mortality.

Frequency and changes in trends of leading risk factors of coronary heart disease in women in the city of Novi Sad during a 20-year period

BACKROUND/AIM: From 1984 to 2004 the city of Novi Sad participated through its Health Center "Novi Sad" in the international Multinational MONItoring of Trends and Determinants in CArdiovascular Disease (MONICA) project, as one of the 38 research centers in 21 countries around the world. The aim of this study was to determine frequency and changes of trends in leading risk factors of coronary heart disease (CHD) and to analyze the previous trend of movement of coronary event in women in Novi Sad during a 20-year period. In 2004, the fourth survey within MONICA project was conducted in the city of Novi Sad. The representative sample included 1,041 women between the age of 25 and 74. The prevalence of risk factors in CHD such as smoking, high blood pressure, elevated blood cholesterol, elevated blood glucose and obesity was determined. Also, indicators of risk factors and rates of coronary events in women were compared with the results from MONICA project obtained in previous three screens, as well as with the results from other research centres. chi2-test, linear trend and correlartion coefficient were used in statistical analysis of results obtained. It was observed that during a 20-year period covered by the study, the prevalence of the leading risk factors for the development of CHD in the surveyed women was significantly increasing and in positive correlation with the values of linear trend. Also, the increase of morbidity rates and mortality rates of coronary event were in positive correlation. The decrease was only recorded in the period from 1985-1989 (the implementation of the intervention programme). Upon analysing the increase in prevalence of leading risk factors of CHD and significant increase in the rates of coronary event, we can conclude that health status of women in Novi Sad during a 20-year period was deteriorating.

WHO MONICA Project: What Have We Learned and Where to Go from Here?

The decline in infectious diseases and a rise in chronic diseases, particularly cardiovascular disease (CVD), underlies the health trajectory of the 20th century. While much was known about CVD, particularly myocardial infarction and stroke, population data were problematic. Importantly, the peak and decline of the CVD epidemic in the 1960s and 1970s in some countries was not well recognized, leading to calls for more population-based disease surveillance. The WHO Multinational MONItoring of Trends and Determinants in CArdiovascular Disease (MONICA) Project was the most comprehensive approach to better understanding disease etiology, incidence and trends at the population level. For a period of ten years or more in each center, from the early 1980s to the mid 1990s, MONICA implemented CVD surveillance in 21 countries. It included mortality, morbidity, coronary care, and population-based risk factor surveillance. The study is characterized by well-described methods and high quality data. The findings show large differences between different centers in 21 countries and provide information for disease treatment and prevention. Many MONICA centers continued to actively collect data on populations within their countries. This experience provides a comprehensive approach for CVD patterns in the developed countries and the oncoming epidemic in the developing world.

Integrated approach to prevention and control of cardiovascular diseases

From 1984 to 2004, the city of Novi Sad participated in the international MONICA (Multinational MONItoring of trends and determinants in CArdiovascular disease) project, as one of the 38 research centres form 21 countries around the world and in CINDI (Countrywide Integrated Noncommunicable Disease Intervention Programme) programme. Objective was to indicate the advantages of the integrated approach to prevention and control of the cardiovascular disease (CVD) over mono-programmes and still present curative approach. Additional objective was the assessment of the vulnerability from the leading risk factors of the population of Novi Sad, based on the results and experience gained in realization of international projects. We analysed the results obtained in the countries where MONICA project and CINDI programme have been applied. The results of their application in Novi Sad are analysed (the trend of the prevalence of risk factors, the incidence of coronary and cerebrovascular events). The prevalence of risk factors (except smoking), the incidence of coronary and cerebrovascular events are significantly increasing and are in positive correlation with the values of the linear trend.The decrease was only recorded in 1987 (the implementation of the intervention programme). The review of results and experiences in international projects and programs, clearly indicate the advantage of an integrated approach to prevention and control of CVD in relation to monoprograme. The great vulnerability of the population of Novi Sad of the risk factors of CVD points out the necessity of their reductions by the principles of integrated programmes of prevention and control.

Hospital discharge data for assessing myocardial infarction events and trends, and effects of diagnosis validation according to MONICA and AHA criteria

BackgroundAcute myocardial infarction (AMI; ICD9-CM 410*) is a leading cause of morbidity and mortality all over the world, and its community surveillance is essential to monitor variation in the occurrence...

Apolipoprotein E gene polymorphism and total serum cholesterol level in Iranian population

Apolipoprotein E (APOE) is known as a major regulator of blood lipid levels in humans. A number of APOE gene allelic variants have been reported including E2, E3 and E4. Recent studies suggested a role for APOE in obesity and increased Body Mass Index (BMI) and plasma lipid levels in obese children. The aim of this study was to examine the association between APOE genetic variants and the BMI and lipid profile in an Iranian cohort. Samples were obtained from subjects who participated in a study based on the WHO-designed MONICA (multinational monitoring of trends and determinants in cardiovascular disease) study for coronary artery disease risk assessment in Zone 17 of Tehran. The study was approved by the local ethical committee. Informed consent was obtained from all subjects included in this study. Subjects (n=320) were recruited. The level of triglyceride (TG) and total serum cholesterol was tested for all subjects in this study. Genotyping for APOE was carried using polymerase chain reaction-Restriction fragment length polymorphism (PCR-RFLP)technique. Levels of significance were determined using contingency tables by either Chi-square or Fisher exact analysis using the STATA (v8) software. The analysis of regression and significance of differences for level of cholesterol and TG was established by one-way analysis of variance followed by Dunnett post hoc multiple comparison tests using SPSS software Version 11.5. The frequency of allele E2 was significantly higher in patients with total serum cholesterol level <200 mg/dl (P 0.01 OR 2.1 95% CI 1.1-4.2). The association found in this study between allele E2 and lower total cholesterol level had been reported in previous studies. We have also observed that the frequency of genotype E2/E3 and E2/E4 was significantly higher in patients with normal total serum cholesterol level compared to patients with abnormal cholesterol (P=0.003 OR 2.4 95% CI; 1.3-4.6). Our data needs to be repeated in a larger population with more information for serum LDL and HDL levels and their subgroups.