The TLGS is a prospective cohort study conducted on a general population in district 13 of Tehran. The first and second registration phases were on January 31, 1999–July 03, 2001 and October 20, 2001–September 22, 2005, respectively, and the cohort examinations were repeated every 3 years. The TLGS had an original aim of assessment the prevalence and incidence of non-communicable diseases and their risk factors. Also, the impact of changes in lifestyle factors was determined in this cohort. The design, measurement methods, and enrollment strategy of the study have been explained in detail by Azizi et al. [21]

From a total of 9558 participants aged ≥ 30 years, 1525 participants were individuals with T2DM. Firstly, we excluded 249 and 11 individuals with prevalent CVD and cancer at baseline, respectively, leading to 1265 participants. Those with missing data on weight measurement at baseline and first follow-up visit and missing data on relevant covariates were also excluded (n = 459). No follow-up information was another reason for exclusion (n = 43). Finally, we included 763 eligible subjects with T2DM (635 subjects from phase I and 128 new subjects from phase II) in our analysis.

As shown in Fig. 1, for participants who were enrolled at phase I (baseline measurement), after about 3 years, phase II was set for follow-up measurement of weight. Moreover, for those enrolled at phase II (baseline measurement), follow-up measurement of weight was done at phase III (2005–2008). After these two weight measurements for weight change calculation, participants were followed-up annually for incident CVD/CHD up to 20 March 2018.

Timeline of the study design: Tehran Lipid and Glucose Study, Iran, 1999–2018

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