Five lipid-inflammation composite indices and obesity-related metabolic disorders, cardiovascular and renal diseases A multi-state trajectory analysis using data from the UK Biobank cohort
Authors' conclusion
RCII is independently associated with the progression from metabolic disorders to cardiorenal diseases in obesity. It may serve as a clinically biomarker for early risk stratification.
Study context
- Population
- Obese adults in the UK Biobank, followed across four stages: obesity (Stage 1), metabolic disorders (Stage 2), cardiorenal disease (Stage 3) and death (Stage 4)
- Participants
- 109,442 obese adults
- Exposure
- Five baseline lipid-inflammation composite indices and stage transitions
- Outcome
- Transition-specific risks across obesity → metabolic disorders → cardiorenal disease → death
- Follow-up
- Median 15.73 years
Methodological detailsmulti-state trajectory analysis, UK Biobank, Markov multistate models, Cox regression, restricted cubic spline analyses
- Multi-state trajectory analysis, UK Biobank
- Markov multistate models
- Cox regression
- Restricted cubic spline analyses
Main finding
As reported in the abstract
Progression from Stage 2 (metabolic disorders) to Stage 3 (cardiorenal disease), fully adjusted model
ApoB/A1-CRP, HR (95% CI 1.00-1.14), P = 0.048
1.07
RCII, HR (95% CI 1.01-1.15), P = 0.017
1.08
Observational data: associations, not effects.
Further findings
Stage progression · median follow-up 15.73 years
- Progressed from Stage 1 to 2
- 11.14%
- Progressed from Stage 2 to 3
- 25.88%
Mortality after cardiorenal disease onset (Stage 3 stratification)
- NHR was primarily associated with mortality following cardiorenal disease onset
Non-linearity (RCS analyses)
- Significant non-linear associations for ApoB/A1-CRP, RCII and NHR
Sensitivity analysis
- RCII demonstrates robustness in sensitivity analysis
Original publication
Five lipid-inflammation composite indices and obesity-related metabolic disorders, cardiovascular and renal diseases A multi-state trajectory analysis using data from the UK Biobank cohort. Diabetes Res Clin Pract. Published 4 April 2026. doi:10.
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