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The trajectories of cardiometabolic multimorbidity associate with mortality risk: a study based on Guangdong adult chronic diseases and risk factors cohort
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DOI：10.3389/fpubh.2026.1833156.png)
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Abstract
En 中文
BackgroundCardiometabolic multimorbidity (CMM) prevalence has risen; but longitudinal evidence on trajectories and mortality links remains limited.ObjectiveThis study aimed to examine CMM trends and the impact of its statuses/trajectories on mortality in Guangdong; China.DesignThis is a cohort study.SettingData were collected from the Guangdong Provincial adult chronic diseases and risk factors cohort (GDACRC). The follow-up data were collected from the hospitalization record system and the vital register system in Guangdong Province.ParticipantsBaseline surveys were separately conducted in 2007; 2010; 2013; 2015; and 2018; which recruited 34; 244 participants aged 18 years or older.MeasurementsCalculated age-sex standardized CMM prevalence. Cox proportional hazards models were used to assess the associations between CMM statuses/trajectories and mortality risk.ResultsFrom 2007 to 2018; the prevalence of CMM increased significantly from 4.31 to 8.75% in Guangdong Province; China (p < 0.05). Compared with participants without any cardiometabolic diseases (CMD); the mortality risk of those with single CMD and CMM; respectively; increased by 30 and 85%; with a greater risk of patients aged < 65 years. The most common trajectory was from metabolic disease (M) to cardiovascular diseases (C); that 9.31% healthy participants at baseline developed CMM on this trajectory; which accounted for 53.5% of all CMM patients. Compared to patients with single M; patients with the trajectory from C to M had greater mortality risk (HR = 3.32; 95% CI: 2.13–5.16).LimitationSingle-province sample; self-report bias.ConclusionCMM represents a major public health challenge in Guangdong Province; China. Our findings provide new insights on the CMM progression; which may be helpful for prevention and clinical management of CMM.
Keywords:
mortality
cardiometabolic multimorbidity
cohort study
disease trajectories
chornic disease
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