| Title: | Transition-Specific Associations of Cardiometabolic Biomarker Burden With Cardio-Renal-Metabolic Multimorbidity Progression: A Multistate Cohort Study |
| Journal: | Diabetes Obesity and Metabolism |
| Published: | 14 Oct 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42870539/ |
| DOI: | https://doi.org/10.1111/dom.71427 |
Publication 21519
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Abstract
AIMS: To identify representative cardiometabolic biomarkers and examine how individual biomarkers and combined biomarker burden are associated with transition-specific progression of cardio-renal-metabolic multimorbidity (CRMM).</p>
METHODS: This prospective cohort study included 262 464 UK Biobank participants free of cardiovascular disease (CVD), type 2 diabetes (T2D) and chronic kidney disease (CKD) at baseline. Forty-nine candidate biomarkers across five domains, including inflammation, insulin resistance, dyslipidemia, adiposity and blood pressure, were evaluated using time-dependent area under the curve and concordance index to select representative markers. Multistate models estimated associations of individual biomarkers, elevated-marker count and a weighted 5-Item Cardiometabolic Risk Score (5-CMRS) with sequential transitions from baseline to first cardio-renal-metabolic disease (FCRMD), FCRMD to Double CRMD and Double to Triple CRMD.</p>
RESULTS: During a median follow-up of 15.62 years, 44 339 participants developed FCRMD, 7218 progressed to Double CRMD and 721 progressed to Triple CRMD. Five representative biomarkers were selected: C-reactive protein-to-albumin ratio, metabolic score for insulin resistance (METS-IR), triglyceride-to-HDL cholesterol ratio, waist-to-height ratio and systolic blood pressure. Higher elevated-marker count showed graded associations across all transitions. Compared with the lowest 5-CMRS category, the highest category was associated with hazard ratios of 2.80, 1.84 and 1.71 for the three sequential transitions. Disease-specific analyses showed the strongest associations with incident T2D. METS-IR showed the largest relative contributions across all transitions, whereas additive interactions were mainly observed during early CRMM progression.</p>
CONCLUSION: Combined cardiometabolic biomarker burden was associated with graded, transition-specific risks across CRMM progression, supporting integrated cardiometabolic risk assessment across inflammatory, metabolic, adiposity, lipid and blood-pressure domains.</p>
9 Authors
- Xiaoqing Li
- Juan Peng
- Jingjing Quan
- Dongdong Zhang
- Li Chen
- Mengqian Liu
- Yan Zhang
- Bin Yi
- Zhijun Huang
1 Application
| Application ID | Title |
|---|---|
| 90060 | Associations of Lifestyle, Environmental factor, Genetic Risk with Aging-related Diseases |
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