Lifestyle factors and their relative contributions to longitudinal progression of cardio-renal-metabolic multimorbidity: a prospective cohort study
Authors' conclusion
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.
Study context
- Population
- UK Biobank participants; Cardio-renal-metabolic multimorbidity (CRMM) = coexistence of two or three of cardiovascular disease (CVD), T2D and chronic kidney disease (CKD)
- Participants
- 357,554 participants
- Exposure
- Per lifestyle score increase
- Outcome
- Longitudinal progression from healthy to first cardio-renal-metabolic disease (FCRMD), then to CRMM, and to death
- Follow-up
- Median 13.62 years
Methodological detailsmultistate model, quantile G-computation
- Multistate model
- Quantile G-computation
Main finding
As reported in the abstract
Transitions per lifestyle score increase
- HR per score increase, healthy to first cardio-renal-metabolic disease (FCRMD)
- 0.91 (95% CI 0.90, 0.91)
- HR per score increase, FCRMD to CRMM
- 0.90 (95% CI 0.89, 0.91)
- HR per score increase, mortality from healthy
- 0.84 (95% CI 0.83, 0.86)
- HR per score increase, mortality from FCRMD
- 0.87 (95% CI 0.86, 0.89)
- HR per score increase, mortality from CRMM
- 0.90 (95% CI 0.88, 0.93)
Observational data: associations, not effects.
Further findings
Relative contribution of lifestyle factors (quantile G-computation)
- Smoking status, whole disease progression
- 19.88-38.10%
- High-risk diet, FCRMD to CRMM (largest)
- 22.53%
- Less-frequent social connection, FCRMD to death (largest)
- 28.81%
Disease-specific transitions
- Lifestyle scores had slightly stronger associations with development to T2D than to CVD or CKD
Original publication
Lifestyle factors and their relative contributions to longitudinal progression of cardio-renal-metabolic multimorbidity: a prospective cohort study. Cardiovasc Diabetol. Published 18 July 2024. doi:10.
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