Duration-dependent impact of cardiometabolic diseases and multimorbidity on all-cause and cause-specific mortality: a prospective cohort study of 0.5 million participants
Abstract Background The 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 t...
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | Cardiovascular Diabetology |
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| Online Access: | https://doi.org/10.1186/s12933-023-01858-9 |
| _version_ | 1797801551726641152 |
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| author | Yuting Han Yizhen Hu Canqing Yu Dianjianyi Sun Yuanjie Pang Pei Pei Ling Yang Yiping Chen Huaidong Du Jingchao Liu Dan Schmidt Daniel Avery Junshi Chen Zhengming Chen Liming Li Jun Lv |
| author_facet | Yuting Han Yizhen Hu Canqing Yu Dianjianyi Sun Yuanjie Pang Pei Pei Ling Yang Yiping Chen Huaidong Du Jingchao Liu Dan Schmidt Daniel Avery Junshi Chen Zhengming Chen Liming Li Jun Lv |
| author_sort | Yuting Han |
| collection | DOAJ |
| description | Abstract Background The 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. Methods Data 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. Results During 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. Conclusion Among 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. |
| first_indexed | 2024-03-13T04:52:39Z |
| format | Article |
| id | doaj.art-12c5e2fa72654610a34012b0ae5865f0 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-03-13T04:52:39Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-12c5e2fa72654610a34012b0ae5865f02023-06-18T11:05:51ZengBMCCardiovascular Diabetology1475-28402023-06-0122111010.1186/s12933-023-01858-9Duration-dependent impact of cardiometabolic diseases and multimorbidity on all-cause and cause-specific mortality: a prospective cohort study of 0.5 million participantsYuting Han0Yizhen Hu1Canqing Yu2Dianjianyi Sun3Yuanjie Pang4Pei Pei5Ling Yang6Yiping Chen7Huaidong Du8Jingchao Liu9Dan Schmidt10Daniel Avery11Junshi Chen12Zhengming Chen13Liming Li14Jun Lv15Department of Epidemiology & Biostatistics, School of Public Health, Peking UniversityDepartment of Epidemiology & Biostatistics, School of Public Health, Peking UniversityDepartment of Epidemiology & Biostatistics, School of Public Health, Peking UniversityDepartment of Epidemiology & Biostatistics, School of Public Health, Peking UniversityDepartment of Epidemiology & Biostatistics, School of Public Health, Peking UniversityPeking University Center for Public Health and Epidemic Preparedness & ResponseMedical Research Council Population Health Research Unit at the University of OxfordMedical Research Council Population Health Research Unit at the University of OxfordMedical Research Council Population Health Research Unit at the University of OxfordNCDs Prevention and Control Department, Wuzhong CDCClinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of OxfordClinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of OxfordChina National Center for Food Safety Risk AssessmentClinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of OxfordDepartment of Epidemiology & Biostatistics, School of Public Health, Peking UniversityDepartment of Epidemiology & Biostatistics, School of Public Health, Peking UniversityAbstract Background The 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. Methods Data 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. Results During 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. Conclusion Among 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.https://doi.org/10.1186/s12933-023-01858-9Cardiometabolic diseaseMultimorbidityMortalityProspective cohort |
| spellingShingle | Yuting Han Yizhen Hu Canqing Yu Dianjianyi Sun Yuanjie Pang Pei Pei Ling Yang Yiping Chen Huaidong Du Jingchao Liu Dan Schmidt Daniel Avery Junshi Chen Zhengming Chen Liming Li Jun Lv 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 Cardiometabolic disease Multimorbidity Mortality Prospective cohort |
| title | Duration-dependent impact of cardiometabolic diseases and multimorbidity on all-cause and cause-specific mortality: a prospective cohort study of 0.5 million participants |
| title_full | Duration-dependent impact of cardiometabolic diseases and multimorbidity on all-cause and cause-specific mortality: a prospective cohort study of 0.5 million participants |
| title_fullStr | Duration-dependent impact of cardiometabolic diseases and multimorbidity on all-cause and cause-specific mortality: a prospective cohort study of 0.5 million participants |
| title_full_unstemmed | Duration-dependent impact of cardiometabolic diseases and multimorbidity on all-cause and cause-specific mortality: a prospective cohort study of 0.5 million participants |
| title_short | Duration-dependent impact of cardiometabolic diseases and multimorbidity on all-cause and cause-specific mortality: a prospective cohort study of 0.5 million participants |
| title_sort | duration dependent impact of cardiometabolic diseases and multimorbidity on all cause and cause specific mortality a prospective cohort study of 0 5 million participants |
| topic | Cardiometabolic disease Multimorbidity Mortality Prospective cohort |
| url | https://doi.org/10.1186/s12933-023-01858-9 |
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