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Lifestyle factors and their relative contributions to longitudinal progression of cardio-renal-metabolic multimorbidity: a prospective cohort study.
- Source :
-
Cardiovascular diabetology [Cardiovasc Diabetol] 2024 Jul 18; Vol. 23 (1), pp. 265. Date of Electronic Publication: 2024 Jul 18. - Publication Year :
- 2024
-
Abstract
- Background: The role of lifestyle factors and their relative contributions to the development and mortality of cardio-renal-metabolic multimorbidity (CRMM) remains unclear.<br />Methods: A study was conducted with 357,554 UK Biobank participants. CRMM was defined as the coexistence of two or three cardio-renal-metabolic diseases (CRMDs), including cardiovascular disease (CVD), type 2 diabetes (T2D) and chronic kidney disease (CKD). The prospective study examined the associations of individual and combined lifestyle scores (diet, alcohol consumption, smoking, physical activity, sedentary behavior, sleep duration and social connection) with longitudinal progression from healthy to first cardio-renal-metabolic disease (FCRMD), then to CRMM, and ultimately to death, using a multistate model. Subsequently, quantile G-computation was employed to assess the relative contribution of each lifestyle factor.<br />Results: During a median follow-up of 13.62 years, lifestyle played crucial role in all transitions from healthy to FCRMD, then to CRMM, and ultimately to death. The hazard ratios (95% CIs) per score increase were 0.91 (0.90, 0.91) and 0.90 (0.89, 0.91) for healthy to FCRMD, and for FCRMD to CRMM, and 0.84 (0.83, 0.86), 0.87 (0.86, 0.89), and 0.90 (0.88, 0.93) for mortality risk from healthy, FCRMD, and CRMM, respectively. Among the seven factors, smoking status contributed to high proportions for the whole disease progression, accounting for 19.88-38.10%. High-risk diet contributed the largest proportion to the risk of transition from FCRMD to CRMM, with 22.53%. Less-frequent social connection contributed the largest proportion to the risk of transition from FCRMD to death, with 28.81%. When we further consider the disease-specific transitions, we find that lifestyle scores had slightly stronger associations with development to T2D than to CVD or CKD.<br />Conclusions: Our study indicates that a healthy lifestyle may have a protective effect throughout the longitudinal progression of CRMM, informing more effective management and treatment. Smoking status, diet, and social connection played pivotal roles in specific disease transitions.<br /> (© 2024. The Author(s).)
- Subjects :
- Humans
Prospective Studies
Male
Female
Middle Aged
Aged
Longitudinal Studies
Time Factors
Risk Assessment
United Kingdom epidemiology
Adult
Risk Factors
Prognosis
Risk Reduction Behavior
Smoking epidemiology
Smoking adverse effects
Smoking mortality
Exercise
Databases, Factual
Alcohol Drinking epidemiology
Alcohol Drinking adverse effects
Alcohol Drinking mortality
Disease Progression
Renal Insufficiency, Chronic epidemiology
Renal Insufficiency, Chronic mortality
Renal Insufficiency, Chronic diagnosis
Renal Insufficiency, Chronic physiopathology
Multimorbidity
Cardiovascular Diseases epidemiology
Cardiovascular Diseases mortality
Cardiovascular Diseases diagnosis
Cardiovascular Diseases prevention & control
Diabetes Mellitus, Type 2 epidemiology
Diabetes Mellitus, Type 2 diagnosis
Diabetes Mellitus, Type 2 mortality
Life Style
Subjects
Details
- Language :
- English
- ISSN :
- 1475-2840
- Volume :
- 23
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Cardiovascular diabetology
- Publication Type :
- Academic Journal
- Accession number :
- 39026309
- Full Text :
- https://doi.org/10.1186/s12933-024-02347-3