Multimorbidity patterns and association with mortality in 0.5 million Chinese adults

Abstract

Background: Few studies have assessed the relationship between multimorbidity patterns and mortality risk in the Chinese population. We aimed to identify multimorbidity patterns and examined the associations of multimorbidity patterns and the number of chronic diseases with the risk of mortality among Chinese middle-aged and older adults. Methods: We used data from the China Kadoorie Biobank and included 512,723 participants aged 30 to 79 years. Multimorbidity was defined as the presence of two or more of the 15 chronic diseases collected by self-report or physical examination at baseline. Multimorbidity patterns were identified using hierarchical cluster analysis. Cox regression was used to estimate the associations of multimorbidity patterns and the number of chronic diseases with all-cause and cause-specific mortality. Results: Overall, 15.8% of participants had multimorbidity. The prevalence of multimorbidity increased with age and was higher in urban than rural participants. Four multimorbidity patterns were identified, including cardiometabolic multimorbidity (diabetes, coronary heart disease, stroke, and hypertension), respiratory multimorbidity (tuberculosis, asthma, and chronic obstructive pulmonary disease), gastrointestinal and hepatorenal multimorbidity (gallstone disease, chronic kidney disease, cirrhosis, peptic ulcer, and cancer), and mental and arthritis multimorbidity (neurasthenia, psychiatric disorder, and rheumatoid arthritis). During a median of 10.8 years of follow-up, 49,371 deaths occurred. Compared with participants without multimorbidity, cardiometabolic multimorbidity (hazard ratios [HR] = 2.20, 95% confidence intervals [CI]: 2.14À2.26) and respiratory multimorbidity (HR = 2.13, 95% CI:1.97À2.31) demonstrated relatively higher risks of mortality, followed by gastrointestinal and hepatorenal multimorbidity (HR = 1.33, 95% CI:1.22À1.46). The mortality risk increased by 36% (HR = 1.36, 95% CI: 1.35À1.37) with every additional disease. Conclusion: Cardiometabolic multimorbidity and respiratory multimorbidity posed the highest threat on mortality risk and deserved particular attention in Chinese adults.

Correlation between the triglyceride-to-high-density lipoprotein cholesterol ratio and other unconventional lipid parameters with the risk of prediabetes and Type 2 diabetes in patients with coronary heart disease: a RCSCD-TCM study in China

“…Moreover, as an essential risk factor for CHD, DM can exacerbate the progression of atherosclerosis, resulting in poor clinical outcomes [ 3 , 4 ]. A 2022 study in China by Junning Fan et al on 500,000 Chinese has shown that diseases, including CHD and DM, greatly portend the risk of mortality among Chinese adults [ 5 ]. The management of glucose metabolism in patients with CHD is therefore particularly important.…”

Sex-specific association between coffee consumption and incident chronic kidney disease: a population-based analysis of 359,906 participants from the UK Biobank

“…Chronic kidney disease (CKD) is a major public health problem with substantial comorbidities and disease burden. The statistics from the Global Burden of Disease Study 2017 reveal that approximately one-tenth of the world's population was affected by CKD, and that it ranked as the 12th leading cause of death globally, causing 35.8 million disability-adjusted life years in 2017 [1,2] …”

Association of the gut microbiota with coronary artery disease and myocardial infarction: A Mendelian randomization study

“…In a cohort of 0.5 million Chinese adults, the multimorbidity rate was 15.8%. The highest mortality is caused by cardiometabolic multimorbidity, and any combination of cardiometabolic Frontiers in Genetics frontiersin.org multimorbidity has a multiplicative mortality risk (Fan et al, 2022). The gut-heart axis has been proposed on the basis of accumulating evidence that gut dysbiosis plays a crucial part in the progression of atherosclerosis.…”