TP53 single nucleotide polymorphism (rs1042522) in Iranian patients with coronary artery disease

Omrani‑Nava,Versa; Hedayatizadeh‑Omran,Akbar; Alizadeh‑Navaei,Reza; Mokhberi,Vahid; Jalalian,Rozita; Janbabaei,Ghasem; Amjadi,Omolbanin; Rahmatpour,Ghasem; Mozaffari,Amir

doi:10.3892/br.2018.1121

TP53 single nucleotide polymorphism (rs1042522) in Iranian patients with coronary artery disease

Authors:
- Versa Omrani‑Nava
- Akbar Hedayatizadeh‑Omran
- Reza Alizadeh‑Navaei
- Vahid Mokhberi
- Rozita Jalalian
- Ghasem Janbabaei
- Omolbanin Amjadi
- Ghasem Rahmatpour
- Amir Mozaffari
View Affiliations

Affiliations: Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48166‑33131, Iran, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran 48471-91971, Iran
Published online on: July 2, 2018 https://doi.org/10.3892/br.2018.1121
Pages: 259-265

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Chronic diseases including coronary artery disease (CAD) impose a high burden in terms of mortality and disability particularly in developing countries. Both genetic and environmental risk factors confer susceptibility to CAD. Meanwhile, a functional polymorphism in the tumor protein p53 (TP53) gene (codon 72, exon 4) has been reported to be associated with a wide range of cancers and inflammatory disorders. There are controversies regarding CAD and involvement of the TP53 codon 72 single nucleotide polymorphism; therefore, the present case‑control study was conducted to evaluate the potential association between this TP53 polymorphism and CAD in an Iranian population. A total of 153 subjects (including 70 patients diagnosed with CAD and 83 subjects with normal coronary parameters, determined by angiography) were genotyped for the TP53 (rs1042522) polymorphism by the polymerase chain reaction‑restriction fragment length polymorphism technique. Clinical and laboratory findings were also evaluated. The χ2 test and unpaired Student's t‑test were applied to compare genotype and allele distributions and clinical characteristics between the two groups. Significant associations of the Pro72 allele [odds ratio (OR)=1.66, P=0.027] and Pro/Pro genotype (OR=2.91, P=0.022) with CAD were identified. No associations between patients' clinical findings and genotypes were apparent. Therefore, according to present findings, the TP53 Pro72 allele may be involved in the development of CAD along with conventional risk factors in patients from Northern Iran.

View Figures

View References

1	Hedayatizadeh-Omran A, Rafiei A, Khajavi R, Alizadeh-Navaei R, Mokhberi V and Moradzadeh K: Association between ghrelin gene (Leu72Met) polymorphism and ghrelin serum level with coronary artery diseases. DNA Cell Biol. 33:95–101. 2014. View Article : Google Scholar : PubMed/NCBI
2	Safdari R, Maleki M and Ghorbani V: Comparison of Cardiovascular Diseases Classification in some developed countries with Iran. Payavard Salamat. 3:50–56. 2009.
3	Kounis NG, Soufras GD, Tsigkas G and Hahalis G: White blood cell counts, leukocyte ratios, and eosinophils as inflammatory markers in patients with coronary artery disease. Clin Appl Thromb Hemost. 21:139–143. 2015. View Article : Google Scholar : PubMed/NCBI
4	Nasehi MM, Moosazadeh M, Âmiresmaeili M, Parsaee M, Zakizadeh R and Mirzajani M: Prevalence of five main risk factors of non-communicable diseases in mazandaran province: A population based study. J Mazandaran Univ Med Sci. 21:193–202. 2012.
5	Boutayeb A: The double burden of communicable and non-communicable diseases in developing countries. Trans R Soc Trop Med Hyg. 100:191–199. 2006. View Article : Google Scholar : PubMed/NCBI
6	Kolahdoozan S, Sadjadi A, Radmard AR and Khademi H: Five common cancers in Iran. Arch Iran Med. 13:143–146. 2010.PubMed/NCBI
7	Naghavi M, Abolhassani F, Pourmalek F, Jafari N, Lakeh Moradi M, Eshrati B, Hezaveh Mahdavi N, Kazemeini H, Banihashemi Tehrani A and Shoaee SH: The burden of disease and injury in Iran in the year 2003. Iranian J Epidemiol. 4:1–19. 2008.
8	World Health Organization: Noncommunicable diseases (NCD) country profiles. 2014.http://www.who.int/nmh/countries/irn_en.pdf?ua=1
9	Hedayatizadeh-Omran A, Rafiei A, Alizadeh-Navaei R, Tehrani M, Valadan R, Moradzadeh K, Panbechi M and Taghavi SM: Role of HER2 in brain metastasis of breast cancer: A systematic review and meta-analysis. Asian Pac J Cancer Prev. 16:1431–1434. 2015. View Article : Google Scholar : PubMed/NCBI
10	Rasouli M, Kiasari Mohseni A, Mokhberi V, Bagheri B, Daneshpour NS, Shariati R, et al: Global risk assessment of coronary heart disease using Framingham's scores for major risk factors. Majallah-i Danishgah-i Ulum-i Pizishki-i Mazandaran. 15:49–62. 2006.
11	Hatmi ZN, Tahvildari S, Motlag Gafarzadeh A and Kashani Sabouri A: Prevalence of coronary artery disease risk factors in Iran: A population based survey. BMC Cardiovasc Disord. 7:322007. View Article : Google Scholar : PubMed/NCBI
12	Golchin Mafi M, Ghaderian SMH, Akhavan-Niaki H, Jalalian R, Heidari L and Salami SA: Analysis of two CDKN2B-AS polymorphisms in relation to coronary artery disease patients in north of Iran. Int J Mol Cell Med. 6:31–37. 2017.PubMed/NCBI
13	den Hoed M, Strawbridge RJ, Almgren P, Gustafsson S, Axelsson T, Engström G, de Faire U, Hedblad B, Humphries SE, Lindgren CM, et al: GWAS-identified loci for coronary heart disease are associated with intima-media thickness and plaque presence at the carotid artery bulb. Atherosclerosis. 239:304–310. 2015. View Article : Google Scholar : PubMed/NCBI
14	Bergamaschi D, Gasco M, Hiller L, Sullivan A, Syed N, Trigiante G, Yulug I, Merlano M, Numico G, Comino A, et al: p53 polymorphism influences response in cancer chemotherapy via modulation of p73-dependent apoptosis. Cancer Cell. 3:387–402. 2003. View Article : Google Scholar : PubMed/NCBI
15	Kung CP, Leu JI, Basu S, Khaku S, Anokye-Danso F, Liu Q, George DL, Ahima RS and Murphy ME: The P72R polymorphism of p53 predisposes to obesity and metabolic dysfunction. Cell Reports. 14:2413–2425. 2016. View Article : Google Scholar : PubMed/NCBI
16	Kawashima H, Takatori H, Suzuki K, Iwata A, Yokota M, Suto A, Minamino T, Hirose K and Nakajima H: Tumor suppressor p53 inhibits systemic autoimmune diseases by inducing regulatory T cells. J Immunol. 191:3614–3623. 2013. View Article : Google Scholar : PubMed/NCBI
17	Chung WC, Lee KM, Lee BI, Chun JS, Lee SY, Chang UI, Park SH, Yang JM, Choi KY and Chung IS: P53 genetic polymorphism of gastric cancer in Korea. Korean J Intern Med (Korean Assoc Intern Med). 21:28–32. 2006.
18	Kumar V, Abbas AK and Aster JC: Robbins and Cotran Pathologic Basis of Disease. 9th edition. Elsevier; New York, NY: 2015
19	Naccarati A, Polakova V, Pardini B, Vodickova L, Hemminki K, Kumar R and Vodicka P: Mutations and polymorphisms in TP53 gene - an overview on the role in colorectal cancer. Mutagenesis. 27:211–218. 2012. View Article : Google Scholar : PubMed/NCBI
20	McGraw KL, Cluzeau T, Sallman DA, Basiorka AA, Irvine BA, Zhang L, Epling-Burnette PK, Rollison DE, Mallo M, Sokol L, et al: TP53 and MDM2 single nucleotide polymorphisms influence survival in non-del(5q) myelodysplastic syndromes. Oncotarget. 6:34437–34445. 2015. View Article : Google Scholar : PubMed/NCBI
21	Doosti A, Dehkordi Ghasemi P, Zamani M, Taheri S, Banitalebi M and Mahmoudzadeh M: Association of the p53 codon 72 polymorphism with colorectal cancer in South West of Iran. Sci Res Essays. 6(10): 58972011.
22	Kung CP and Murphy ME: The role of the p53 tumor suppressor in metabolism and diabetes. J Endocrinol. 231:R61–R75. 2016. View Article : Google Scholar : PubMed/NCBI
23	Liu DP, Song H and Xu Y: A common gain of function of p53 cancer mutants in inducing genetic instability. Oncogene. 29:949–956. 2010. View Article : Google Scholar : PubMed/NCBI
24	Sadeghi Najjar R, Azimzadeh P, Vahedi M, Mirsattari D, Molaei M, Mohebbi S, et al: Profile and frequency of p53 gene alterations in gastritis lesions from Iran 2010. 65–75
25	Soleimani A, Rahmani Y, Farshchian N, Delpisheh A, Khassi K, Shahmohammadi A and Amirifard N: The Evaluation of p53 polymorphism at codon 72 and association with breast cancer in Iran: A systematic review and meta-analysis. J Cancer Prev. 21:288–293. 2016. View Article : Google Scholar : PubMed/NCBI
26	Tang W, Zhou X, Nie S, Yang Z, Zhu H, Wu X, Zhao R and Luo Y: Association of p53 Arg72Pro polymorphism with gastric cancer: A meta-analysis. Biomarkers. 17:597–603. 2012. View Article : Google Scholar : PubMed/NCBI
27	Kankova K: Association of the Arg72Pro polymorphism in p53 with progression of diabetic nephropathy in T2DM subjects. J Nephrol Ther. 4:1532014. View Article : Google Scholar
28	Xu Y, Yao L, Ouyang T, Li J, Wang T, Fan Z, Lin B, Lu Y and Xie Y: p53 codon 72 polymorphism predicts the pathologic response to neoadjuvant chemotherapy in patients with breast cancer. Clin Cancer Res. 11:7328–7333. 2005. View Article : Google Scholar : PubMed/NCBI
29	Vikhanskaya F, Siddique MM, Lee Kei M, Broggini M and Sabapathy K: Evaluation of the combined effect of p53 codon 72 polymorphism and hotspot mutations in response to anticancer drugs. Clin Cancer Res. 11:4348–4356. 2005. View Article : Google Scholar : PubMed/NCBI
30	Frank AK, Leu JI, Zhou Y, Devarajan K, Nedelko T, Klein-Szanto A, Hollstein M and Murphy ME: The codon 72 polymorphism of p53 regulates interaction with NF-{kappa}B and transactivation of genes involved in immunity and inflammation. Mol Cell Biol. 31:1201–1213. 2011. View Article : Google Scholar : PubMed/NCBI
31	Alkhalaf M, Al-Bustan S, Hamoda H and Abdella N: Polymorphism of p53 gene codon 72 in Kuwaiti with coronary artery disease and diabetes. Int J Cardiol. 115:1–6. 2007. View Article : Google Scholar : PubMed/NCBI
32	Gloria-Bottini F, Banci M, Saccucci P, Neri A, Bottini E and Magrini A: p53 codon 72 polymorphism and coronary artery disease: Evidence of interaction with ACP₁. Med Sci Monit. 18:CR712–CR715. 2012. View Article : Google Scholar : PubMed/NCBI
33	Manfredi S, Masetti S, Botto N, Colombo MG, Terrazzi M, Vassalle C, Biagini A and Andreassi MG: P53 codon 72 polymorphism in coronary artery disease: No evidence for association with increased risk or micronucleus frequency. Environ Mol Mutagen. 40:110–115. 2002. View Article : Google Scholar : PubMed/NCBI
34	Judkins MP: Selective coronary arteriography. I. A percutaneous transfemoral technic. Radiology. 89:815–824. 1967. View Article : Google Scholar : PubMed/NCBI
35	Khan S, Phulukdaree A, Ramkaran P, Moodley D and Chuturgoon AA: The Arg72 variant of the p53 functional polymorphism (rs1042522) is associated with coronary artery disease in young South Africans of Indian ancestry. Gene. 593:261–264. 2016. View Article : Google Scholar : PubMed/NCBI
36	Ara S, Lee PS, Hansen MF and Saya H: Codon 72 polymorphism of the TP53 gene. Nucleic Acids Res. 18:49611990. View Article : Google Scholar : PubMed/NCBI
37	Morris JA and Gardner MJ: Calculating confidence intervals for relative risks (odds ratios) and standardised ratios and rates. Br Med J (Clin Res Ed). 296:1313–1316. 1988. View Article : Google Scholar : PubMed/NCBI
38	Sikka S and Sikka P: Association of human papilloma virus 16 infection and p53 polymorphism among tobacco using oral leukoplakia patients: A clinicopathologic and genotypic study. Int J Prev Med. 5:430–438. 2014.PubMed/NCBI
39	Sadeghi M, Haghdoost AA, Bahrampour A and Dehghani M: Modeling the burden of cardiovascular diseases in Iran from 2005 to 2025: The impact of demographic changes. Iran J Public Health. 46:506–516. 2017.PubMed/NCBI
40	Maracy MR, Isfahani MT, Kelishadi R, Ghasemian A, Sharifi F, Shabani R, Djalalinia S, Majidi S, Ansari H, Asayesh H, et al: Burden of ischemic heart diseases in Iran, 1990–2010: Findings from the global burden of disease study 2010. J Res Med Sci. 20:1077–1083. 2015. View Article : Google Scholar : PubMed/NCBI
41	Ebrahimi M, Kazemi-Bajestani SM, Ghayour-Mobarhan M and Ferns GA: Coronary artery disease and its risk factors status in Iran: A review. Iran Red Crescent Med J. 13:610–623. 2011. View Article : Google Scholar : PubMed/NCBI
42	Hirashiki A, Yamada Y, Murase Y, Suzuki Y, Kataoka H, Morimoto Y, Tajika T, Murohara T and Yokota M: Association of gene polymorphisms with coronary artery disease in low- or high-risk subjects defined by conventional risk factors. J Am Coll Cardiol. 42:1429–1437. 2003. View Article : Google Scholar : PubMed/NCBI
43	Satti HS, Hussain S and Javed Q: Association of interleukin-6 gene promoter polymorphism with coronary artery disease in Pakistani families. ScientificWorldJournal. 2013:5383652013. View Article : Google Scholar : PubMed/NCBI
44	Saccucci P, Banci M, Amante A, Bottini E and Gloria-Bottini F: Coronary artery disease: Evidence of interaction between PTPN22 and p53 genetic polymorphisms. Cardiology. 120:166–168. 2011. View Article : Google Scholar : PubMed/NCBI
45	Gu J, Spitz MR, Zhao H, Lin J, Grossman HB, Dinney CP and Wu X: Roles of tumor suppressor and telomere maintenance genes in cancer and aging - an epidemiological study. Carcinogenesis. 26:1741–1747. 2005. View Article : Google Scholar : PubMed/NCBI
46	Grizzi F and Chiriva-Internati M: Cancer: Looking for simplicity and finding complexity. Cancer Cell Int. 6:42006. View Article : Google Scholar : PubMed/NCBI
47	Dastjerdi MN, Hasanzadeh M, Talebi A and Akbari M: Investigation of p53 codon 72 polymorphism in patients with nonmelanoma skin cancers in Isfahan. Majallah-i Danishkadah-i Pizishki-i Isfahan. 29:679–685. 2011.
48	Malekzadeh R, Bishehsari F, Mahdavinia M and Ansari R: Epidemiology and molecular genetics of colorectal cancer in Iran: A review. Arch Iran Med. 12:161–169. 2009.PubMed/NCBI
49	Bonafé M, Ceccarelli C, Farabegoli F, Santini D, Taffurelli M, Barbi C, Marzi E, Trapassi C, Storci G, Olivieri F, et al: Retention of the p53 codon 72 arginine allele is associated with a reduction of disease-free and overall survival in arginine/proline heterozygous breast cancer patients. Clin Cancer Res. 9:4860–4864. 2003.PubMed/NCBI
50	Neamatzadeh H, Soleimanizad R, Atefi A, Zare-Shehneh M, Gharibi S, Shekari A and Rahimzadeh AB: Association between p53 codon 72 (Arg72Pro) polymorphism and primary open-angle glaucoma in Iranian patients. Iran Biomed J. 19:51–56. 2015.PubMed/NCBI
51	Moradi MT, Salehi Z, Aminian K and Yazdanbod A: Effects of p53 codon 72 and MDM2 SNP309 polymorphisms on gastric cancer risk among the Iranian population. Asian Pac J Cancer Prev. 15:7413–7417. 2014. View Article : Google Scholar : PubMed/NCBI
52	Hedayatizadeh-Omran A, Alizadeh-Navaei R, Janbabaei G, Omrani-Nava V, Hasheminasab Y, Amjadi O and Tehrani M: Association of P53 gene polymorphism with gastric cancer in Northern Iran as a high-risk region. Biomed Rep. 8:433–438. 2018.PubMed/NCBI
53	Mojtahedi Z, Hashemi SB, Khademi B, Karimi M, Haghshenas MR, Fattahi MJ and Ghaderi A: p53 codon 72 polymorphism association with head and neck squamous cell carcinoma. Rev Bras Otorrinolaringol (Engl Ed). 76:316–320. 2010.
54	Sina M, Pedram M, Ghojazadeh M, Kochaki A and Aghbali A: P53 gene codon 72 polymorphism in patients with oral squamous cell carcinoma in the population of northern Iran. Med Oral Patol Oral Cir Bucal. 19:e550–e555. 2014. View Article : Google Scholar : PubMed/NCBI
55	Gerayli S, Pasdar A, Rostami S, Sepahi S, Hoseini Mousalreza S, Jahanian R, Gholoobi A, Meshkat Z and Ahadi M: Association of codon 72 of p53 gene polymorphism with chronic hepatitis C virus infection: A case control study. J Cell Mol Res. 8:46–51. 2016.
56	Huxley RR, Ansary-Moghaddam A, Clifton P, Czernichow S, Parr CL and Woodward M: The impact of dietary and lifestyle risk factors on risk of colorectal cancer: A quantitative overview of the epidemiological evidence. Int J Cancer. 125:171–180. 2009. View Article : Google Scholar : PubMed/NCBI
57	Ahmad A, Banerjee S, Wang Z, Kong D, Majumdar AP and Sarkar FH: Aging and inflammation: Etiological culprits of cancer. Curr Aging Sci. 2:174–186. 2009. View Article : Google Scholar : PubMed/NCBI
58	Lopez-Candales A, Burgos Hernández PM, Hernandez-Suarez DF and Harris D: Linking chronic inflammation with cardiovascular disease: From normal aging to the metabolic syndrome. J Nat Sci. 3:e3412017.PubMed/NCBI
59	Gloria-Bottini F, Banci M, Saccucci P, Nardi P, Scognamiglio M, Papetti F, Magrini A, Pellegrino A, Bottini E and Chiariello L: p53 codon 72 polymorphism and coronary artery disease: Evidence of association with left ventricular ejection fraction. Am J Med Sci. 343:127–130. 2012. View Article : Google Scholar : PubMed/NCBI
60	Khodadadi A, Shafeie Mir A, Eslami MB, Razavi A and Hekmat K: An investigation upon the effectiveness of LVA-7220 as an immunomodulator on chronic ulcerative colities in rats. Koomesh. 4:151–157. 2003.
61	Vietri MT, Riegler G, Ursillo A, Caserta L, Cioffi M and Molinari AM: p53 codon 72 polymorphism in patients affected with ulcerative colitis. J Gastroenterol. 42:456–460. 2007. View Article : Google Scholar : PubMed/NCBI
62	Vaji S, Salehi Z and Aminian K: Association of p53 codon 72 genetic polymorphism with the risk of ulcerative colitis in northern Iran. Int J Colorectal Dis. 26:235–238. 2011. View Article : Google Scholar : PubMed/NCBI
63	Lagares MH, Silva KSF, Barbosa AM, Rodrigues DA, Costa IR, Martins JVM, Morais MP, Campedelli FL and Moura KKVO: Analysis of p53 gene polymorphism (codon 72) in symptomatic patients with atherosclerosis. Genet Mol Res. 16:1–9. 2017. View Article : Google Scholar
64	Caamaño J, Saavedra N, Jaramillo PC, Lanas C, Lanas F and Salazar LA: TP53 codon 72 polymorphism is associated with coronary artery disease in Chilean subjects. Med Princ Pract. 20:171–176. 2011. View Article : Google Scholar : PubMed/NCBI
65	Ye H, Li X, Wang L, Liao Q, Xu L, Huang Y, Xu L, Xu X, Chen C, Wu H, et al: Genetic associations with coronary heart disease: Meta-analyses of 12 candidate genetic variants. Gene. 531:71–77. 2013. View Article : Google Scholar : PubMed/NCBI
66	Frostegård J: Atherosclerosis in patients with autoimmune disorders. Arterioscler Thromb Vasc Biol. 25:1776–1785. 2005. View Article : Google Scholar : PubMed/NCBI
67	Renjith AS, Marwaha V, Aggarwal N, Koshy V, Singal VK and Kumar KVSH: Prevalence of left ventricular dysfunction in rheumatoid arthritis. J Family Med Prim Care. 6:622–626. 2017. View Article : Google Scholar : PubMed/NCBI
68	Ostanek L, Ostanek-Pańka M, Bobrowska-Snarska D, Bińczak-Kuleta A, Fischer K, Kaczmarczyk M, Ciechanowicz A and Brzosko M: PTPN22 1858C>T gene polymorphism in patients with SLE: Association with serological and clinical results. Mol Biol Rep. 41:6195–6200. 2014. View Article : Google Scholar : PubMed/NCBI
69	Abbasi Z, Nezhad Kazemi SR, Pourmahdi-Broojeni M and Rajaei E: Association of PTPN22 rs2476601 Polymorphism with rheumatoid arthritis and celiac disease in Khuzestan province, southwestern Iran. Iran Biomed J. 21:61–66. 2017. View Article : Google Scholar : PubMed/NCBI
70	Jafari-Adli S, Jouyandeh Z, Qorbani M, Soroush A, Larijani B and Hasani-Ranjbar S: Prevalence of obesity and overweight in adults and children in Iran; a systematic review. J Diabetes Metab Disord. 13:1212014. View Article : Google Scholar : PubMed/NCBI
71	Davoodi SH, Malek-Shahabi T, Malekshahi-Moghadam A, Shahbazi R and Esmaeili S: Obesity as an important risk factor for certain types of cancer. Iran J Cancer Prev. 6:186–194. 2013.PubMed/NCBI
72	Ahmadi A, Mobasheri M and Soori H: Prevalence of major coronary heart disease risk factors in Iran. Int J Epidemiol Res. 1:3–8. 2014.
73	Monfared AB, Hatami H and Isabeiglou H: Prevalence and associated factors of overweight and obesity in reproductive-aged women in Rasht. J Health Field. 4:39–46. 2016.
74	Shahri Mahdavi SM, Khalili Z, Sadrollahi A and Saadati B: Prevalence of risk factors for cardiovascular disease among elderly people in Kashan city, Iran, 2014. Cardiovasc Nurs J. 3:6–13. 2014.
75	Sadeghi M, Talaei M, Oveisgharan S, Rabiei K, Dianatkhah M, Bahonar A and Sarrafzadegan N: The cumulative incidence of conventional risk factors of cardiovascular disease and their population attributable risk in an Iranian population: The Isfahan Cohort Study. Adv Biomed Res. 3:2422014. View Article : Google Scholar : PubMed/NCBI
76	Italian National Institute of Statistics: Diabetes in Italy (2000–2016). https://www.istat.it/it/files//2017/07/Report_Diabetes_En_def.pdf
77	Eschwege E, Basdevant A, Crine A, Moisan C and Charles MA: Type 2 diabetes mellitus in France in 2012: Results from the ObEpi survey. Diabetes Metab. 41:55–61. 2015. View Article : Google Scholar : PubMed/NCBI
78	Obesity and the Economics of Prevention: Fit not Fat - France Key Facts. http://www.oecd.org/els/health-systems/obesityandtheeconomicsofpreventionfitnotfat-francekeyfacts.htm
79	Rahmani A, Sayehmiri K, Asadollahi K, Sarokhani D, Islami F and Sarokhani M: Investigation of the prevalence of obesity in Iran: A systematic review and meta-analysis study. Acta Med Iran. 53:596–607. 2015.PubMed/NCBI
80	Esteghamati A, Larijani B, Aghajani MH, Ghaemi F, Kermanchi J, Shahrami A, Saadat M, Esfahani EN, Ganji M, Noshad S, et al: Diabetes in Iran: Prospective analysis from first nationwide diabetes report of National Program for Prevention and Control of Diabetes (NPPCD-2016). Sci Rep. 7:134612017. View Article : Google Scholar : PubMed/NCBI
81	Gikas A, Lambadiari V, Sotiropoulos A, Panagiotakos D and Pappas S: Prevalence of major cardiovascular risk factors and coronary heart disease in a sample of Greek adults: The saronikos study. Open Cardiovasc Med J. 10:69–80. 2016. View Article : Google Scholar : PubMed/NCBI
82	Dhingra R and Vasan RS: Age as a risk factor. Med Clin North Am. 96:87–91. 2012. View Article : Google Scholar : PubMed/NCBI
83	Jackson CF and Wenger NK: Cardiovascular disease in the elderly. Rev Esp Cardiol. 64:697–712. 2011. View Article : Google Scholar : PubMed/NCBI
84	Yang HH, Chen Y and Gao CY: Associations of P2Y12R gene polymorphisms with susceptibility to coronary heart disease and clinical efficacy of antiplatelet treatment with clopidogrel. Cardiovasc Ther. 34:460–467. 2016. View Article : Google Scholar : PubMed/NCBI