{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T09:18:16Z","timestamp":1783588696747,"version":"3.55.0"},"reference-count":31,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"unspecified","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013779","name":"Sabzevar University of Medical Sciences","doi-asserted-by":"publisher","award":["98166"],"award-info":[{"award-number":["98166"]}],"id":[{"id":"10.13039\/501100013779","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003969","name":"Iranian Ministry of Health and Medical Education","doi-asserted-by":"crossref","award":["700\/534"],"award-info":[{"award-number":["700\/534"]}],"id":[{"id":"10.13039\/501100003969","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,2,23]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Non-communicable diseases (NCDs) have become the leading cause of mortality globally, with a sharp rise in Iran due to lifestyle changes and urbanisation. Although many NCD risk factors are modifiable, limited understanding of their determinants hinders effective prevention. To address this, the Prospective Epidemiological Research Studies in Iran (PERSIAN) Cohort was established in 2014 to study NCDs nationwide. The Sabzevar PERSIAN Cohort Study (SPECS) is the first in northeastern Iran, aiming to investigate environmental and social factors influencing NCDs in a unique regional context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>SPECS enrolled 5174 adults (aged 35\u201370 years) in northeastern Iran between January 2018 and January 2019 through a census and an online registration process. The baseline data collection included demographic verification, informed consent, health questionnaires, anthropometric measurements and biological samples (blood, urine, hair, nails). The annual follow-up began in April 2019, with full reassessments every 5 years over a 15-year period. The data is gathered via an active and passive follow-up, supported by trained staff and registry linkages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings to date<\/jats:title>\n                    <jats:p>Of the 5174 participants, 4241 (81%) remained in the study. Among the cohort, 54.5% were female, with a mean age of 50.5 years. The majority were married (93.5%), and nearly half had at least high-school education (46.5%) and moderate socioeconomic status (49.4%). Drug abuse history (smoking\/drugs) was reported by about 15% of the sample. The mean body mass index was 26.9\u2009kg\/m\u00b2, and the average blood pressure was higher in males (118.1\/74.0\u2009mm Hg) than in females (111.5\/70.2\u2009mm Hg). The common conditions included hypertension (22.8%), kidney stones (22.4%), fatty liver (15.4%) and diabetes (13.8%). Cancer had the highest treatment rate (100%), while fatty liver had the lowest (70.1%). Stroke had the highest mean age of onset (51.2 years), and epilepsy the lowest (23.7 years). All health data were self-reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Future plans<\/jats:title>\n                    <jats:p>SPECS, part of the national PERSIAN cohort initiative, is the only adult NCD-focused study in Khorasan Razavi. Its 15-year follow-up aims to generate region-specific insights into the incidence of NCDs and their risk factors. The ethnically homogeneous sample enhances statistical power, and the findings may inform culturally tailored health policies. While self-reported data have limitations due to bias, high initial participation and access to free healthcare support long-term engagement, especially among lower-income groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-109896","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:10:31Z","timestamp":1775146231000},"page":"e109896","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["First population-based study on non-communicable diseases and risk factors in northeastern Iran: Sabzevar cohort profile"],"prefix":"10.1136","volume":"16","author":[{"given":"Fereshteh","family":"Ghorat","sequence":"first","affiliation":[{"name":"Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Chaman","sequence":"additional","affiliation":[{"name":"Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyed Alireza","family":"Javadinia","sequence":"additional","affiliation":[{"name":"Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mojtaba","family":"Rad","sequence":"additional","affiliation":[{"name":"Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran (the Islamic Republic of)"},{"name":"School of Paramedicine, Sabzevar University of Medical Sciences, Sabzevar, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Mohammadzadeh","sequence":"additional","affiliation":[{"name":"Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazem","family":"Hassanpour","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Sabzevar University of Medical Sciences, Sabzevar, Razavi Khorasan Province, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1600-747X","authenticated-orcid":false,"given":"Elaheh","family":"Foroumandi","sequence":"additional","affiliation":[{"name":"Sabzevar University of Medical Sciences, Sabzevar, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0576-8874","authenticated-orcid":false,"given":"Milad","family":"Nazarzadeh","sequence":"additional","affiliation":[{"name":"Sabzevar University of Medical Sciences Non-Communicable Diseases Research Center, Sabzevar, Razavi Khorasan Province, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Hossien","family":"Saghi","sequence":"additional","affiliation":[{"name":"Sabzevar University of Medical Sciences, Sabzevar, Razavi Khorasan Province, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Salari","sequence":"additional","affiliation":[{"name":"Sabzevar University of Medical Sciences, Sabzevar, Razavi Khorasan Province, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeinab","family":"Bidel","sequence":"additional","affiliation":[{"name":"Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Razavi Khorasan Province, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sareh","family":"Eghtesad","sequence":"additional","affiliation":[{"name":"Liver and Pancreatobiliary Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Gohari","sequence":"additional","affiliation":[{"name":"Sabzevar University of Medical Sciences, Sabzevar, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Mohammadi","sequence":"additional","affiliation":[{"name":"Liver and Pancreatobiliary Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roholla","family":"Borghabani","sequence":"additional","affiliation":[{"name":"Sabzevar University of Medical Sciences, Sabzevar, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3643-8680","authenticated-orcid":false,"given":"Mohmmad Mahdi","family":"Ghorbani","sequence":"additional","affiliation":[{"name":"Sabzevar University of Medical Sciences, Sabzevar, Razavi Khorasan Province, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Moslem","sequence":"additional","affiliation":[{"name":"Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1695-3810","authenticated-orcid":false,"given":"Somaye","family":"Norouzi","sequence":"additional","affiliation":[{"name":"Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"2026070902002288000_16.4.e109896.1","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-024-58629-z","article-title":"Trend and projection of non-communicable diseases risk factors in Iran from 2001 to 2030","volume":"14","author":"Farzadfar","year":"2024","journal-title":"Sci Rep"},{"key":"2026070902002288000_16.4.e109896.2","first-page":"51","article-title":"Cardiovascular Risk-Factors in the Eastern Iranian Population: Are We Approaching 25\u00d725 Target?","volume":"16","author":"Siadat","year":"2016","journal-title":"J Res Health Sci"},{"key":"2026070902002288000_16.4.e109896.3","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1016\/S0140-6736(18)31992-5","article-title":"NCD Countdown 2030: worldwide trends in non-communicable disease mortality and progress towards Sustainable Development Goal target 3.4","volume":"392","author":"Bennett","year":"2018","journal-title":"The Lancet"},{"key":"2026070902002288000_16.4.e109896.4","doi-asserted-by":"crossref","first-page":"e644","DOI":"10.1016\/S2214-109X(17)30200-0","article-title":"Reframing non-communicable diseases as socially transmitted conditions","volume":"5","author":"Allen","year":"2017","journal-title":"Lancet Glob Health"},{"key":"2026070902002288000_16.4.e109896.5","doi-asserted-by":"crossref","DOI":"10.1177\/2040622319880392","article-title":"Common risk factors for major noncommunicable disease, a systematic overview of reviews and commentary: the implied potential for targeted risk reduction","volume":"10","author":"Peters","year":"2019","journal-title":"Ther Adv Chronic Dis"},{"key":"2026070902002288000_16.4.e109896.6","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2020.574111","article-title":"Management and Prevention Strategies for Non-communicable Diseases (NCDs) and Their Risk Factors","volume":"8","author":"Budreviciute","year":"2020","journal-title":"Front Public Health"},{"key":"2026070902002288000_16.4.e109896.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2012.10.022"},{"key":"2026070902002288000_16.4.e109896.8","doi-asserted-by":"crossref","DOI":"10.1186\/s12992-014-0081-9","article-title":"Non-communicable diseases (NCDs) in developing countries: a symposium report","volume":"10","author":"Islam","year":"2014","journal-title":"Global Health"},{"key":"2026070902002288000_16.4.e109896.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.07.020"},{"key":"2026070902002288000_16.4.e109896.10","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2010.200261"},{"key":"2026070902002288000_16.4.e109896.11","first-page":"3769","article-title":"Non-communicable diseases: Awareness of risk factors and lifestyle among rural adolescents","volume":"5","author":"Ade","year":"2014","journal-title":"Int J Biol Med Res"},{"key":"2026070902002288000_16.4.e109896.12","first-page":"691","article-title":"The PERSIAN Cohort: Providing the Evidence Needed for Healthcare Reform","volume":"20","author":"Eghtesad","year":"2017","journal-title":"Arch Iran Med"},{"key":"2026070902002288000_16.4.e109896.13","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwx314"},{"key":"2026070902002288000_16.4.e109896.14","unstructured":"Sabzevar. Available: https:\/\/en.wikipedia.org\/wiki\/Sabzevar [Accessed 5 Dec 2025]."},{"key":"2026070902002288000_16.4.e109896.15","unstructured":"Sabzevar, Available: https:\/\/itto.org\/iran\/city\/Sabzevar [Accessed 5 Dec 2025]."},{"key":"2026070902002288000_16.4.e109896.16","doi-asserted-by":"crossref","DOI":"10.1186\/s12937-024-00938-0","article-title":"Validity and reproducibility of the PERSIAN Cohort food frequency questionnaire: assessment of major dietary patterns","volume":"23","author":"Eghtesad","year":"2024","journal-title":"Nutr J"},{"key":"2026070902002288000_16.4.e109896.17","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-022-13444-x","article-title":"Socioeconomic inequalities in prevalence, awareness, treatment and control of hypertension: evidence from the PERSIAN cohort study","volume":"22","author":"Amini","year":"2022","journal-title":"BMC Public Health"},{"key":"2026070902002288000_16.4.e109896.18","doi-asserted-by":"crossref","first-page":"2921","DOI":"10.1007\/s13300-021-01152-5","article-title":"Nationwide Prevalence of Diabetes and Prediabetes and Associated Risk Factors Among Iranian Adults: Analysis of Data from PERSIAN Cohort Study","volume":"12","author":"Khamseh","year":"2021","journal-title":"Diabetes Ther"},{"key":"2026070902002288000_16.4.e109896.19","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejcn.1602407"},{"key":"2026070902002288000_16.4.e109896.20","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114511006313"},{"key":"2026070902002288000_16.4.e109896.21","unstructured":"Manual AP . National health and nutrition examination survey. Atlanta, Ga, USA, 2007."},{"key":"2026070902002288000_16.4.e109896.22","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1093\/ije\/dyy296","article-title":"Cohort Profile: Ravansar Non-Communicable Disease cohort study: the first cohort study in a Kurdish population","volume":"48","author":"Pasdar","year":"2019","journal-title":"Int J Epidemiol"},{"key":"2026070902002288000_16.4.e109896.23","first-page":"279","article-title":"Tabari Cohort Profile and Preliminary Results in Urban Areas and Mountainous Regions of Mazandaran, Iran","volume":"22","author":"Kheradmand","year":"2019","journal-title":"Arch Iran Med"},{"key":"2026070902002288000_16.4.e109896.24","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s10654-020-00668-7","article-title":"The profile of Rafsanjan Cohort Study","volume":"36","author":"Hakimi","year":"2021","journal-title":"Eur J Epidemiol"},{"key":"2026070902002288000_16.4.e109896.25","doi-asserted-by":"crossref","first-page":"e172","DOI":"10.1093\/ije\/dyac241","article-title":"Cohort Profile: The Fasa Adults Cohort Study (FACS): a prospective study of non-communicable diseases risks","volume":"52","author":"Homayounfar","year":"2023","journal-title":"Int J Epidemiol"},{"key":"2026070902002288000_16.4.e109896.26","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2023-079697","article-title":"Cohort profile: the PERSIAN Dena Cohort Study (PDCS) of non-communicable diseases in Southwest Iran","volume":"14","author":"Harooni","year":"2024","journal-title":"BMJ Open"},{"key":"2026070902002288000_16.4.e109896.27","article-title":"Cohort profile: The Hoveyzeh Cohort Study (HCS): A prospective population-based study on non-communicable diseases in an Arab community of Southwest Iran","volume":"34","author":"Cheraghian","year":"2020","journal-title":"Med J Islam Repub Iran"},{"key":"2026070902002288000_16.4.e109896.28","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyy215"},{"key":"2026070902002288000_16.4.e109896.29","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0265388","article-title":"Cohort profile: Bandar Kong prospective study of chronic non-communicable diseases","volume":"17","author":"Nejatizadeh","year":"2022","journal-title":"PLoS ONE"},{"key":"2026070902002288000_16.4.e109896.30","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyp161"},{"key":"2026070902002288000_16.4.e109896.31","doi-asserted-by":"crossref","first-page":"e350","DOI":"10.1093\/ije\/dyac011","article-title":"Cohort Profile: The Zahedan Adult Cohort Study (ZACS)-a prospective study of non-communicable diseases in Sistani and Baluch populations","volume":"51","author":"Shahraki-Sanavi","year":"2022","journal-title":"Int J Epidemiol"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-109896","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T09:00:43Z","timestamp":1783587643000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-109896"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":31,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4,2]]},"published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1136\/bmjopen-2025-109896"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-109896","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]}}}