Duration-dependent impact of cardiometabolic diseases and multimorbidity on all-cause and cause-specific mortality: a prospective cohort study of 0.5 million participants

Cardiovascular Diabetology

Research

Junshi Chen¹  Dan Schmidt²  Daniel Avery²  Zhengming Chen²  Yizhen Hu³  Yuting Han³  Yuanjie Pang⁴  Jun Lv⁵  Dianjianyi Sun⁵  Liming Li⁵  Canqing Yu⁵  Ling Yang⁶  Huaidong Du⁶  Yiping Chen⁶  Jingchao Liu⁷  Pei Pei⁸ 

[1] China National Center for Food Safety Risk Assessment, Beijing, China;Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK;Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China;Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China;Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China;Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China;Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China;Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China;Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK;Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK;NCDs Prevention and Control Department, Wuzhong CDC, Suzhou, Jiangsu, China;Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China;

关键词: Cardiometabolic disease;    Multimorbidity;    Mortality;    Prospective cohort;   

DOI  :  10.1186/s12933-023-01858-9

 received in 2023-04-26, accepted in 2023-05-12,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe association of incident cardiometabolic multimorbidity (CMM) with mortality risk is rarely studied, and neither are the durations of cardiometabolic diseases (CMDs). Whether the association patterns of CMD durations with mortality change as individuals progress from one CMD to CMM is unclear.MethodsData from China Kadoorie Biobank of 512,720 participants aged 30–79 was used. CMM was defined as the simultaneous presence of two or more CMDs of interest, including diabetes, ischemic heart disease, and stroke. Cox regression was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the duration-dependent associations of CMDs and CMM with all-cause and cause-specific mortality. All information on exposures of interest was updated during follow-up.ResultsDuring a median follow-up of 12.1 years, 99,770 participants experienced at least one incident CMD, and 56,549 deaths were documented. Among 463,178 participants free of three CMDs at baseline, compared with no CMD during follow-up, the adjusted HRs (95% CIs) between CMM and all-cause mortality, mortality from circulatory system diseases, respiratory system diseases, cancer, and other causes were 2.93 (2.80–3.07), 5.05 (4.74–5.37), 2.72 (2.35–3.14), 1.30 (1.16–1.45), and 2.30 (2.02–2.61), respectively. All CMDs exhibited a high mortality risk in the first year of diagnosis. Subsequently, with prolonged disease duration, mortality risk increased for diabetes, decreased for IHD, and sustained at a high level for stroke. With the presence of CMM, the above association estimates inflated, but the pattern of which remained.ConclusionAmong Chinese adults, mortality risk increased with the number of the CMDs and changed with prolonged disease duration, the patterns of which varied among the three CMDs.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 1