Medical Journal of the Islamic Republic of Iran最新文献

{"title":"Social Determinants of Health in Iran: Policy Evolution, Intersectoral Governance, and Equity Monitoring.","authors":"Hamid Reza Baradaran, Ali Azimi, Mohsen Asadi-Lari, Marzieh Khadem Sharif, Sara Aghababa, Shadrokh Sirous, Alireza Olyaeemanesh, Ahad Bakhtiari, Efat Mohamadi","doi":"10.47176/mjiri.40.33","DOIUrl":"10.47176/mjiri.40.33","url":null,"abstract":"<p><strong>Background: </strong>The Social Determinants of Health (SDH) encompass the systemic conditions shaping daily life and health outcomes. In the Islamic Republic of Iran, health equity and SDH have been institutionalized as core components of sustainable national policy to address the \"causes of the causes\" behind health disparities. This study aims to evaluate the strategic evolution of Iran's health system, focusing on upstream SDH policies, intersectoral institutional frameworks, national research productivity, and the longitudinal development of monitoring mechanisms established to identify and mitigate inequities.</p><p><strong>Methods: </strong>This is a policy review article with qualitative key-informant input, covering the initiation of SDH efforts through the end of 2023. The study analyzed 25 national upstream policies, the functionality of 32 effective intersectoral councils, and the outputs of 38 specialized SDH research centers. Primary data were gathered through 26 semi-structured interviews with key authorities conducted between 2020 and 2023 and verified through member checking.</p><p><strong>Results: </strong>Since the 1980s, Iran has established significant infrastructure, primarily through the Primary Health Care (PHC) network. Key reforms include the Universal Health Insurance Act (1994) and the Comprehensive Welfare and Social Security System (2004). Governance is driven by the Supreme Council of Health and Food Safety. While research output is robust-exceeding 4,200 indexed articles-operational challenges persist, including a 39% out-of-pocket expenditure rate, overlapping council mandates, and the deteriorating impact of international sanctions on equitable access.</p><p><strong>Conclusion: </strong>Iran possesses an advanced architecture for tracking 69 health equity indicators. However, reducing disparities requires moving beyond indicator collection to sustained political commitment, legally institutionalized intersectoral alignment, and translating data into targeted socioeconomic interventions.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"33"},"PeriodicalIF":0.0,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physicians' Attitudes Toward Unnecessary Medical Services: Ethical and Systemic Challenges in Fourth Level Prevention - Tehran 2024.","authors":"Mohsen Saberi Isfeedvajani, Esmat Davoudi-Monfared, Jannat Mashayekhi, Sajjad Bahra, Mahboubeh Rouhollahei","doi":"10.47176/mjiri.40.32","DOIUrl":"10.47176/mjiri.40.32","url":null,"abstract":"<p><strong>Background: </strong>The provision of unnecessary services within healthcare systems is prevalent, costly, prone to complications, and detrimental to patient care. The aim of the present study is to examine physicians' attitudes toward unnecessary tests and procedures at a referring hospital.</p><p><strong>Methods: </strong>This study was conducted as a cross-sectional study. The sampling population comprised all physicians employed at a referral University Hospital in 2024. The study utilized a validated questionnaire to collect data over a 6-month period. Analyses were reported descriptively for qualitative variables as frequency and percentage, and for quantitative variables as mean and standard deviation. Chi-square tests and Fisher's exact test were employed for comparisons. Analyses were conducted using SPSS-22.0.</p><p><strong>Results: </strong>A total of 196 physicians participated in the study, with a mean age of 34.69 (± 9.29) years and an average of 9.45 (± 6.36) years of clinical experience. Approximately 89.8% of the participants regarded the repetition of unnecessary tests and procedures as a significant issue within the healthcare system. About 92.3% reported that patients sometimes or rarely comply with physicians' recommendations to avoid unnecessary procedures. Furthermore, 55.1% identified patient insistence as the primary reason for prescribing unnecessary services. A substantial 83.2% of physicians believed that spending more time with patients and educating them about alternative tests or procedures would effectively reduce unnecessary services. Additionally, 81.6% of physicians considered reforms in medical malpractice follow-up to be effective in decreasing unnecessary service prescriptions, while 88.2% deemed changes to the financing system as effective in this regard. However, 90.8% reported actively working to reduce unnecessary tests. The attitude scores of specialist physicians regarding unnecessary services were significantly higher than those of residents (P-value=0.027).</p><p><strong>Conclusion: </strong>The provision of unnecessary services poses a significant challenge within the healthcare system. The primary causes of this issue include patient insistence and physicians' fear of legal complaints. Addressing this problem necessitates systemic reforms focused on the role of physicians.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"32"},"PeriodicalIF":0.0,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attitudes toward Mobile App Use in Individuals with Type 1 Diabetes Mellitus: A Quasi-Experimental Mixed-Methods Investigation of a Digital Support Tool for Diabetes Self-Management Behavior.","authors":"Fariba Alaei-Shahmiri, Roya Ghafoury, Shahnaz Rimaz, Shakiba Rahimi, Mitra Faghihi, Zohreh Maghsoomi, Mohammad E Khamseh","doi":"10.47176/mjiri.40.31","DOIUrl":"10.47176/mjiri.40.31","url":null,"abstract":"<p><strong>Background: </strong>Mobile applications can enhance diabetes self-management by visualizing glucose trends and promoting engagement. However, evidence on their behavioral and clinical effectiveness in environments with constrained resources remains limited. This study evaluated the impact of the Iranian Asan-Chek mobile app on glycemic outcomes and user experiences among adults with type 1 diabetes mellitus (T1DM).</p><p><strong>Methods: </strong>In a 12-week quasi-experimental mixed-methods study, 148 adults with T1DM were recruited. Seventy-four participants used the Bluetooth-enabled Asan-Chek app (intervention group) and 74 performed structured self-monitoring of blood glucose (control group). Primary outcomes included changes in HbA1c and qualitative insights into user engagement and experience. Semi-structured interviews with 15 purposively selected participants (13 app users, 2 controls, varied in age and diabetes duration) explored attitudes, perceived benefits, and barriers. Transcripts were analyzed thematically.</p><p><strong>Results: </strong>HbA1c decreased by 0.62% in the app group and by 0.41% in the control group (both <i>P</i> < 0.001), without any notable divergence between the intervention and control participants (<i>P</i> = 0.202). Changes in BMI, insulin requirements, and glycemic variability during the course of the study exhibited no statistical disparity between the two groups. Qualitative analysis uncovered three motifs: (i) heightened self efficacy and perceived control arising from instant feedback; (ii) stronger motivation prompted by color coded trend charts and reminders and (iii) usability and economic barriers: interface complexity, data driven anxiety, test strip cost, and finger prick fatigue.</p><p><strong>Conclusion: </strong>Over twelve weeks, qualitative results highlighted that the Asan-Chek app provided motivational and behavioral advantages for individuals with T1DM but did not outperform structured SMBG in attaining HbA1c targets. Addressing challenges through optimized app interface, comprehensive user training, affordable supplies via reimbursement, and AI-driven feedback may help convert these behavioral gains into lasting glycemic improvement.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Strategies to Promote Iran's Role in EMRO by Supporting WHOCCs.","authors":"Arman Zargaran","doi":"10.47176/mjiri.40.30","DOIUrl":"10.47176/mjiri.40.30","url":null,"abstract":"","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"30"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and Strategies of Newborn Hearing Screening Programs Worldwide: A Scoping Review.","authors":"Ehsan Moradi-Joo, Somayeh Noori Hekmat, Hoda Ghobeishipour, Hoda Hamedpour, Mohsen Davarpanah, Mohsen Barouni, Saeid Mahmoudian","doi":"10.47176/mjiri.40.29","DOIUrl":"10.47176/mjiri.40.29","url":null,"abstract":"<p><strong>Background: </strong>Newborn hearing screening (NHS) programs are essential public health initiatives aimed at early detection of neonatal deafness, thereby reducing long-term developmental delays. However, resource limitations, including insufficient infrastructure, workforce shortages, and financial constraints, significantly hinder program effectiveness. This scoping review investigates the key challenges and strategies implemented across various global newborn hearing screening programs.</p><p><strong>Methods: </strong>A systematic scoping review approach was employed, following established field review methodologies. Studies were retrieved from PubMed/Medline, Cochrane Library, Embase, INAHTA, Google Scholar, and regional academic databases using targeted search strategies tailored to each platform's protocol. Articles published between 2000/01/01 and 2024/01/30 were selected. Eligibility criteria and selection processes were defined to ensure comprehensiveness and study quality. Data extraction was conducted via a structured Excel 2013 form, systematically compiling general and specific study details.</p><p><strong>Results: </strong>Improving newborn hearing screening programs requires strategic collaboration between decision-makers, healthcare providers, and researchers. Effective planning demands: Expert-driven policy frameworks incorporating scientific recommendations; optimal resource allocation through pilot assessments and real-world evaluations; and strengthened monitoring mechanisms, ensuring high program efficiency.</p><p><strong>Conclusion: </strong>Addressing structural and operational challenges through strategic policy frameworks and resource optimization can substantially enhance newborn hearing screening programs. Scalable interventions-such as expanded telehealth solutions, AI-driven diagnostics, and universal screening implementation-have the potential to increase early detection rates and improve healthcare outcomes for infants with hearing impairments and their families.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"29"},"PeriodicalIF":0.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association between Eye Sign and Capillaroscopy Changes in Patients with Scleroderma Spectrum Disease Presenting with Raynaud's Phenomenon, as Compared to the Normal Population.","authors":"Saeedeh Shenavandeh, Sanaz Dehghani","doi":"10.47176/mjiri.40.28","DOIUrl":"10.47176/mjiri.40.28","url":null,"abstract":"<p><strong>Background: </strong>Capillaroscopy is widely recognized for its role in evaluating microcirculation, particularly in patients with Raynaud's phenomenon and scleroderma-spectrum diseases. The eye sign may provide complementary insights into microvascular assessment. This study primarily investigates whether the eye sign can differentiate patients with systemic sclerosis (SSc) and other connective tissue diseases (CTDs) presenting with Raynaud's from healthy controls. Additionally, we explored correlations between eye sign scores and capillaroscopic changes within patient subgroups.</p><p><strong>Methods: </strong>This cross-sectional study enrolled 117 individuals, divided into three groups: healthy controls (N=31), systemic sclerosis (SSc) (N=49), and other connective tissue diseases (CTDs) presenting with Raynaud's phenomenon (RP) (N=37). Clinical data, including lung involvement, pulmonary artery hypertension, and skin score, as well as laboratory results, capillaroscopy findings, and eye sign (assessed by naked-eye criteria), were collected from all participants. The primary analysis compared ocular symptom scores between patients and healthy controls. Subgroup analyses and correlation assessments were exploratory.</p><p><strong>Results: </strong>Eye sign scores did not significantly differ between the combined patient group and healthy controls (<i>P</i> = 0.158). Subgroup comparisons also revealed no significant differences (<i>P</i> = 0.297 for SSc, <i>P</i> = 0.262 for other CTDs). Furthermore, no significant associations were observed between eye sign scores and capillaroscopy findings within the study groups. Additionally, no significant associations were found between eye sign scores and specific clinical manifestations. Confidence intervals were provided to reflect statistical uncertainty.</p><p><strong>Conclusion: </strong>This study found no statistically significant differences in Eye sign scores between patients and healthy controls, nor any associations with capillaroscopic abnormalities. However, due to the limited sample size and the exploratory nature of the subgroup analyses, these findings should be interpreted with caution.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"28"},"PeriodicalIF":0.0,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing and Validating a Parent Guide to Improve Sleep in Children with Autism Spectrum Disorder: Emphasis on the Holistic Approach to Self-Regulation Strategies.","authors":"Simin Asadi, Samaneh Karamali Esmaili, Laleh Lajevardi, Mahtab Roohi-Azizi, Elham Shirazi, Jamileh Abolghasemi","doi":"10.47176/mjiri.40.27","DOIUrl":"https://doi.org/10.47176/mjiri.40.27","url":null,"abstract":"<p><strong>Background: </strong>Autism spectrum disorder (ASD) frequently coexists with sleep problems. This study, guided by family-centered and general systems theories and acknowledging the reciprocal relationships between sleep and self-regulation, details the process of designing a parent guide aimed at improving sleep in children aged 6-12 years diagnosed with level 1 or 2 ASD.</p><p><strong>Methods: </strong>A literature search was conducted to identify interventions that emphasize self-regulation strategies aimed at improving children's sleep. The content and face validity of this guide were evaluated based on the opinions of experts and parents. In a pilot study, the guide was presented to parents of children with ASD (n = 3) in the form of a booklet, and its effectiveness was assessed through caregiver feedback and the Children's Sleep Habits Questionnaire (CSHQ).</p><p><strong>Results: </strong>The booklet comprises 23 subtitles organized into four chapters: \"Introductory Information,\" \"Child-Related Factors,\" \"Environment-Related Factors,\" and \"Impact of Other Activities on Sleep.\" In this feasibility pilot (n=3), minor reductions (2-3 points) in CSHQ scores were observed; however, this magnitude of change is below typical minimal clinically important differences, and the study was not designed to assess efficacy.</p><p><strong>Conclusion: </strong>The development of a parent guide for sleep of children with ASD was driven by the need to address self-regulatory strategies across three interrelated dimensions: the child, the environment, and sleep itself. This approach is superior to single-domain interventions that do not adequately consider the complex interplay of self-regulation deficits in ASD. This study provides initial evidence for the viability and promise of this intervention, paving the way for definitive future trials.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"27"},"PeriodicalIF":0.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Determinants of Profitability in Iran's Pharmaceutical Industry: A Panel Data Analysis.","authors":"Mohsen Zare, Mohammad Hadian, Ali Tahmasebi","doi":"10.47176/mjiri.40.26","DOIUrl":"10.47176/mjiri.40.26","url":null,"abstract":"<p><strong>Background: </strong>Profitability is a fundamental aspect of corporate survival in the pharmaceutical industry, shaped by both firm-level and macroeconomic factors. In Iran, the sector encounters challenges such as reliance on imports, inflation, and sanctions, alongside a lack of empirical evidence regarding the determinants of profitability. This study aims to fill this gap by investigating these factors in listed firms.</p><p><strong>Methods: </strong>Panel data from 28 companies listed on the Tehran Stock Exchange (2009-2023) were analyzed using fixed-effects Feasible Generalized Least Squares (FGLS) regression. The dependent variables were return on assets (ROA) and return on equity (ROE). The independent variables included firm-specific factors (e.g., leverage, sales growth) and macroeconomic factors (e.g., GDP, inflation). Diagnostic tests, including unit root, cointegration, and heteroskedasticity tests, were conducted.</p><p><strong>Results: </strong>Results indicated that GDP, money supply, and sales growth were positively associated with profitability. Conversely, interest rates, exchange rates, inflation, government expenditure, leverage, P/E ratio, and liquidity ratios exhibited negative associations. The effects of firm size and tax revenue were mixed. The models accounted for 69-89% of the variation (R-squared), with significant F-statistics (<i>P</i><0.001). The hypotheses were confirmed, partially supported, or contradicted, as summarized.</p><p><strong>Conclusion: </strong>The profitability of Iranian pharmaceuticals is susceptible to macroeconomic volatility and firm-specific strategies. It is imperative that policies are implemented to stabilize exchange rates and promote domestic production to enhance sustainability.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"26"},"PeriodicalIF":0.0,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key Indicators of Performance-Based Payment to Physicians by Insurance Organizations in Iran.","authors":"Zeinolabedin Abbasi Nowdeh, Khadije Safizade, Seyede Fateme Mousavi Jam, Ebrahim Jaafaripooyan","doi":"10.47176/mjiri.40.25","DOIUrl":"10.47176/mjiri.40.25","url":null,"abstract":"<p><strong>Background: </strong>A fair and transparent payment system has been shown to influence workforce motivation and quality of work. Performance-based payment initiatives are designed to strengthen this relationship by linking compensation to measurable outcomes. This study aimed to identify the key indicators of performance-based payment for physicians in Iran.</p><p><strong>Methods: </strong>This mixed-method study employed a scoping review and semi-structured interviews with key professionals and practitioners in health insurance, health economics, and management. The scoping review followed the Arksey and O'Malley framework and covered publications from 2000 to 2024 in both Persian and English databases. Interview data were analyzed using a thematic analysis approach with the assistance of MAXQDA software. A prioritization matrix was applied to determine the final set of key indicators.</p><p><strong>Results: </strong>Eighteen key indicators were identified through review, qualitative analysis, and screening stages. The main indicators included the per capita number of expensive diagnoses or procedures prescribed within a given period, adherence to clinical guidelines, per capita number of services provided by a physician, and compliance with electronic service delivery (e.g., use of PMR and electronic prescriptions).</p><p><strong>Conclusion: </strong>Key performance indicators and managerial dashboards are critical tools for enhancing efficiency, equity, and quality in the health sector. The use of such indicators by purchasing and insurance organizations can motivate providers to prioritize quality and responsiveness while effectively managing healthcare costs.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"25"},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic Immune-Inflammation Index and Risk of Diabetes and Prediabetes Two Years Post-COVID-19: A Retrospective Cohort Study.","authors":"Ezatollah Rahimi, Lotfollah Saed, Nasrin Moghimi, Solmaz Derakhshan, Parisa Modaresi, Narmin Baghi","doi":"10.47176/mjiri.40.24","DOIUrl":"10.47176/mjiri.40.24","url":null,"abstract":"<p><strong>Background: </strong>Post-COVID-19 metabolic complications, such as diabetes, are linked to systemic inflammation. The Systemic Immune-Inflammation Index (SII) may help predict these outcomes; however, evidence from non-Western populations remains limited.</p><p><strong>Methods: </strong>In this retrospective cohort study, 2,060 COVID-19 patients hospitalized in 2020 in Iran were followed for two years. SII was calculated and categorized as normal or elevated. The incidence of diabetes and prediabetes was assessed using fasting blood sugar (FBS) and HbA1c levels. Linear regression analyses were conducted to examine associations between SII and metabolic outcomes, adjusting for potential confounders.</p><p><strong>Results: </strong>Among participants, 73.4% remained normoglycemic, 7.5% developed prediabetes, and 19.1% developed diabetes. Linear regression analysis demonstrated a statistically significant but modest positive association between SII and FBS levels (β = 0.018; 95% CI: 0.004-0.032; P = 0.011). Other inflammatory markers showed no significant associations.</p><p><strong>Conclusion: </strong>Elevated SII was modestly associated with higher fasting blood sugar levels two years after COVID-19 infection. Although the effect size was small, these findings suggest that systemic inflammation may play a role in long-term glycemic dysregulation, underscoring the importance of metabolic follow-up in individuals with heightened post-COVID inflammatory profiles.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}