| Title: | Associations of Socioeconomic Status With Cardiorenal Metabolic Multimorbidity Evidence From the UK Biobank Cohort |
| Journal: | JACC Advances |
| Published: | 12 Mar 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/41832791/ |
| DOI: | https://doi.org/10.1016/j.jacadv.2026.102646 |
| URL: | http://dx.doi.org/10.1016/j.jacadv.2026.102646 |
Publication 17403
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Abstract
BACKGROUND: Cardiorenal metabolic multimorbidity (CRMM), defined as the coexistence of ≥2 conditions among cardiovascular disease, type 2 diabetes, and chronic kidney disease, imposes a substantial global health burden. Evidence linking socioeconomic status (SES) to CRMM and its progression remains limited, despite SES associations with individual cardiorenal metabolic diseases (CRMDs).</p>
OBJECTIVES: The objective of the study was to examine the associations of SES with CRMM incidence and progression.</p>
METHODS: This prospective cohort study included participants in the UK Biobank. SES (income, education, and employment) was categorized into 3 levels via latent class analysis and summed score. Cox regression models were employed to examine the association between SES and the risk of CRMM, whereas multistate modeling evaluated the dynamic progression of CRMM associated with SES.</p>
RESULTS: During follow-up, 5,643 participants developed CRMM. Compared to high SES, low SES was independently associated with significantly elevated risks of CRMM (HR: 2.03; 95% CI: 1.82 to 2.27). Socioeconomic disparities were observed across all disease transitions, with low SES increasing progression risks from free of CRMD to first CRMD (HR: 1.45; 95% CI: 1.10-1.50), to CRMM (HR: 1.51; 95% CI: 1.43-1.49), and from existing cardiovascular disease (HR: 1.22; 95% CI: 1.12-1.33) or type 2 diabetes (HR: 1.48; 95% CI: 1.19-1.85) to CRMM. Consistent associations were confirmed using the summed SES score.</p>
CONCLUSIONS: Our study establishes SES as a pivotal determinant of CRMM incidence and progression. This underscores the necessity of integrating SES into public health strategies to mitigate the CRMM burden, even in individuals with 1 CRMD.</p>
4 Authors
- Zhiran Guo
- Yaguan Zhou
- Yue Zhang
- Xiaolin Xu
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