Abstract
Purpose
Non-communicable diseases (NCDs) have become a global health priority with a great need for prompt evidence-based preventing and managing interventions. Here, we describe the development of a comprehensive cohort study that provides the most accurate results for NCDs’ risk factors, named the Iran Cohort Study (ICS) to estimate the effect size of the risk factors associated with major NCDs.
Methods
This cohort is an observational prospective study, which its baseline data was gathered through the Iran STEPwise Approach to NCD Risk Factor Surveillance (STEPs) survey in 2016. Following the STROBE criteria, the protocols for investigation of several areas were developed. The follow-up phase began through telephone calls to estimate the effect size of socio-demographic, behavioral, and metabolic risk factors on the incidence of or death due to major NCDs during the three years of study period.
Delinerables
The main deliverables of ICS are planned to be as following; a comprehensive bank of primary data and follow-up data, national and subnational reports on estimation of the effect size of various risk factors, and a policy brief on the policy options and recommendations for promotion of ongoing programs and designing new interventions. Also, the collected data on the individuals’ health status will be sent to the participants as an electronic health record.
Conclusion
The present study is the first comprehensive national and sub-national representative cohort study on NCDs’ risk factors in Iranian adults. The results could be used for promotion of health planning and also future complementary studies and programs.
Data availability
Not applicable.
Code availability
Not applicable.
References
Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2013;380(9859):2197–223.
Peykari N, Sepanlou SG, Djalalinia S, Kasaeian A, Parsaeian M, Ahmadvand A, et al. National and sub-national prevalence, trend, and burden of metabolic risk factors (MRFs) in Iran: 1990–2013, study protocol. Arch Iran Med. 2014;17(1):54–61.
Aminorroaya A, Fattahi N, Azadnajafabad S, Mohammadi E, Jamshidi K, Rouhifard Khalilabad M, et al. Burden of non-communicable diseases in Iran: past, present, and future. J Diabetes Metab Disord. 2020. https://doi.org/10.1007/s40200-020-00669-z.
NCD Risk Factor Collaboration. Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19· 1 million participants. Lancet (London, England). 2017;389(10064):37.
Peykari N, Hashemi H, Dinarvand R, Haji-Aghajani M, Malekzadeh R, Sadrolsadat A, et al. National action plan for non-communicable diseases prevention and control in Iran; a response to emerging epidemic. J Diabetes Metab Disord. 2017;16:3. https://doi.org/10.1186/s40200-017-0288-4.
Naghavi M, Abajobir AA, Abbafati C, Abbas KM, Abd-Allah F, Abera SF, et al. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the global burden of disease study 2016. Lancet. 2017;390(10100):1151–210.
Azadnajafabad S, Mohammadi E, Aminorroaya A, Fattahi N, Rezaei S, Haghshenas R, et al. Non-communicable diseases' risk factors in Iran; a review of the present status and action plans. J Diabetes Metab Disord. 2021:1–9. https://doi.org/10.1007/s40200-020-00709-8.
Djalalinia S, Kelishadi R, Qorbani M, Peykari N, Kasaeian A, Saeedi Moghaddam S, et al. Suggestions for better data presentation in papers: an experience from a comprehensive study on national and sub-national trends of overweight and obesity. Arch Iran Med. 2014;17(12):830–6.
Varmaghani M, Sharifi F, Mehdipour P, Sheidaei A, Djalalinia S, Gohari K, et al. Prevalence of smoking among Iranian adults: findings of the national STEPs survey 2016. Arch Iran Med. 2020;23(6):369–77.
Global Burden of Disease Study 2019 (GBD 2019) Results [database on the Internet]: Institute for Health Metrics and Evaluation (IHME); 2020 [3 May 2021]. Available from: http://ghdx.healthdata.org/gbd-results-tool.
Farzadfar F, Danaei G, Namdaritabar H, Rajaratnam JK, Marcus JR, Khosravi A, et al. National and subnational mortality effects of metabolic risk factors and smoking in Iran: a comparative risk assessment. Popul Health Metrics. 2011;9(1):55. https://doi.org/10.1186/1478-7954-9-55.
Gakidou E, Afshin A, Abajobir AA, Abate KH, Abbafati C, Abbas KM, et al. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet. 2017;390(10100):1345–422.
Djalalinia S, Modirian M, Sheidaei A, Yoosefi M, Zokaiee H, Damirchilu B, et al. Protocol Design for Large-Scale Cross-Sectional Studies of surveillance of risk factors of non-communicable diseases in Iran: STEPs 2016. Arch Iran Med. 2017;20(9):608–16.
Danaei G, Farzadfar F, Kelishadi R, Rashidian A, Rouhani OM, Ahmadnia S, et al. Iran in transition. Lancet. 2019;393(10184):1984–2005. https://doi.org/10.1016/S0140-6736(18)33197-0.
Nikbakht H-A, Rezaianzadeh A, Seif M, Ghaem H. Prevalence of metabolic syndrome and its components among a population-based study in south of Iran, PERSIAN Kharameh cohort study. Clinical Epidemiology and Global Health. 2020;8(3):678–83.
Najafi F, Rezaei S, Hajizadeh M, Soofi M, Salimi Y, Kazemi Karyani A, et al. Decomposing socioeconomic inequality in dental caries in Iran: cross-sectional results from the PERSIAN cohort study. Arch Public Health. 2020;78:75. https://doi.org/10.1186/s13690-020-00457-4.
Mansour-Ghanaei F, Joukar F, Naghipour M, Sepanlou S, Poustchi H, Mojtahedi K, et al. The PERSIAN Guilan cohort study (PGCS). Arch Iran Med. 2019;22(1):39.
Azadnajafabad S, Saeedi Moghaddam S, Mohammadi E, Rezaei N, Haghshenas R, Ghasemi E, et al. Importance of population-wide studies in controlling noncommunicable diseases: achievements of non-communicable diseases research center, endocrinology and metabolism research institute. J Diabetes Metab Disord 2020;20(1 (Special Issue, 25th Anniversary of the Foundation) #HD00276):25–34.
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007;4(10):1–5.
NCD Risk Factor Collaboration. Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet. 2016;387(10027):1513–30. https://doi.org/10.1016/S0140-6736(16)00618-8.
Schmidt H, Gostin L, Emanuel E. Public health, universal health coverage, and sustainable development goals: can they coexist? Lancet (London, England). 2015;386(9996):928.
Eghtesad S, Mohammadi Z, Shayanrad A, Faramarzi E, Joukar F, Hamzeh B, et al. The PERSIAN cohort: providing the evidence needed for healthcare reform. Arch Iran Med. 2017;20(11):691–5.
Djalalinia S, Saeedi Moghaddam S, Sheidaei A, Rezaei N, Naghibi Iravani SS, Modirian M, et al. Patterns of obesity and overweight in the Iranian population: findings of STEPs 2016. Front Endocrinol (Lausanne). 2020;11:42. https://doi.org/10.3389/fendo.2020.00042.
Djalalinia S, Kelishadi R, Qorbani M, Peykari N, Kasaeian A, Nasli-Esfahani E, et al. A systematic review on the prevalence of overweight and obesity, in Iranian children and adolescents. Iran J Pediatr. 2016;26(3):e2599. https://doi.org/10.5812/ijp.2599.
Djalalinia S, Mehdipour P, Mohajer B, Mohebi F, Larijani B, Sepanlou SG, et al. Levels and trends of BMI, obesity, and overweight at national and sub-national levels in Iran from 1990 to 2016; a comprehensive pooled analysis of half a million individuals. Arch Iran Med. 2021;24(5):344–53.
Djalalinia S, Moghaddam SS, Peykari N, Kasaeian A, Sheidaei A, Mansouri A, et al. Mortality attributable to excess body mass index in Iran: implementation of the comparative risk assessment methodology. Int J Prev Med. 2015;6:107. https://doi.org/10.4103/2008-7802.169075.
Fattahi N, Azadnajafabad S, Mohammadi E, Aminorroaya A, Rezaei S, Ghasemi E, et al. Geographical, gender and age inequalities in non-communicable diseases both at national and provincial levels in Iran. J Diabetes Metab Disord. 2021. https://doi.org/10.1007/s40200-020-00713-y.
Mohammadi E, Aminorroaya A, Fattahi N, Azadnajafabad S, Rezaei N, Farzi Y, et al. Epidemiologic pattern of cancers in Iran; current knowledge and future perspective. J Diabetes Metab Disord. 2021;20(1):825–9. https://doi.org/10.1007/s40200-020-00654-6.
Sharifi A, Farzi Y, Roshani S, Ghamari A, Tabatabaei-Malazy O, Djalalinia S, et al. A new model for optimization of diabetes clinics with the case study in Iran. J Diabetes Metab Disord. 2022;21(1):817–22.
Acknowledgments
The authors would like to thank the research experts and staff of the Non-Communicable Diseases Research Center (NCDRC) for their valuable efforts in this study. We also thank for cooperation of all of participants who made this experience possible. The authors would like to thank NIMAD for providing the financial support of this study.
Funding
This study was supported by Grant No. 973048 from the National Institutes for Medical Research Development (NIMAD), Tehran, Iran.
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Conceptualization: FF and SD. Writing – original draft: SD, SA, and FF. Writing – review & editing: SD, SA, NeR, and FF. Data curation and analysis: MRM, EG, MY, and SSM. Project administration: NaR, SN, AG, RH, and YF. All of the authors have read and approved the final manuscript. FF was the corresponding author of this manuscript and supervised all stages of the project and study conduction.
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Ethical approval for the study was obtained from the Ethical Committee of National Institute for Medical Research Development (NIMAD) (code: IR.NIMAD.REC.1397.513).
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Djalalinia, S., Azadnajafabad, S., Rezaei, N. et al. The first nationally and sub-nationally representative non-communicable diseases cohort study in Iran: Iran Cohort Study (ICS) protocol. J Diabetes Metab Disord 22, 913–920 (2023). https://doi.org/10.1007/s40200-022-01143-8
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DOI: https://doi.org/10.1007/s40200-022-01143-8