A Cross‐Nationally Validated Nomogram for Cardiometabolic Multimorbidity in Overweight/Obese Older Adults: China Health and Retirement Longitudinal Study (CHARLS) and Health and Retirement Study (HRS) Cohorts
Authors' conclusion
This nomogram integrating metabolic, functional and psychological predictors demonstrated strong discrimination in the CHARLS cohort and maintained adequate discriminative performance in a cross-national external validation using the US HRS cohort despite differences in population characteristics and measurement instruments
Study context
- Population
- Overweight/obese middle-aged and older adults (body mass index (BMI) ≥ 24.0 kg/m²), CHARLS (2011 and 2015); external validation in US HRSCHARLS 3965
- Participants
- 2,775 / 1,190 / 8,180
- Comparison
- Development vs Validation vs HRS external validation
- Developmentn = 2,775
- Validationn = 1,190
- HRS external validationn = 8,180
- Outcome
- Cardiometabolic multimorbidity (CMM); model performance by AUC, calibration and decision curve analysis
Methodological detailsrandom split development/validation, external validation, LASSO and multivariable logistic regression
- Random split development/validation
- External validation
- LASSO and multivariable logistic regression
Performance
As reported in the abstract
Nomogram discrimination (AUC) for CMM
| Test or model | AUC |
|---|---|
| Development | 0.871 (95% CI: 0.838-0.905) |
| Validation | 0.817 (95% CI: 0.768-0.867) |
| HRS external validation | 0.733 (95% CI: 0.714-0.751) |
AUC
Development0.871 (95% CI: 0.838-0.905)
Validation0.817 (95% CI: 0.768-0.867)
HRS external validation0.733 (95% CI: 0.714-0.751)
- Eight predictors retained: residence, Activities of daily living (ADL) score, CESD-10 score, haemoglobin A1c (HbA1c), hypertension, arthritis, dyslipidaemia, memory disorder
- 8
Further findings
- Cardiometabolic multimorbidity (CMM) prevalence
- 3.91%
Original publication
A Cross‐Nationally Validated Nomogram for Cardiometabolic Multimorbidity in Overweight/Obese Older Adults: CHARLS and HRS Cohorts. Diabetes Obes Metab. Published 6 July 2026. doi:10.
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