Lee Sangjun, Ahn Choonghyun, Abe Sarah Krull, Rahman Md Shafiur, Islam Md Rashedul, Saito Eiko, An Seokyung, Sawada Norie, Shu Xiao-Ou, Koh Woon-Puay, Cai Hui, Hozawa Atsushi, Kanemura Seiki, Nagata Chisato, You San-Lin, Kang Daehee, Kanehara Rieko, Gao Yu-Tang, Yuan Jian-Min, Wen Wanqing, Sugawara Yumi, Wada Keiko, Chen Chien-Jen, Yoo Keun-Young, Ahsan Habibul, Chia Kee Seng, Shin Aesun, Kim Jeongseon, Lee Jung Eun, Matsuo Keitaro, Rothman Nathaniel, Qiao You-Lin, Zheng Wei, Boffetta Paolo, Inoue Manami, Park Sue K
Department of Preventive Medicine, Seoul National University College of Medicine.
Cancer Research Institute, Seoul National University.
J Epidemiol. 2025 May 13;35(7):321-9. doi: 10.2188/jea.JE20240362.
Studies on the association between multimorbidity and mortality in large populations have mainly been conducted in European and North American populations. This study aimed to identify the association between cardiometabolic multimorbidity and all-cause and cardiovascular disease (CVD) mortality in the Asia Cohort Consortium.
In this prospective cohort study, pooled analysis was performed to evaluate the association between cardiometabolic diseases (hypertension, diabetes, ischemic heart disease, and stroke), multimorbidity, and all-cause and CVD mortality, including premature mortality, among participants from 11 Asian cohort studies. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox hazard regression.
A total of 483,532 participants were followed for a median of 14.3 years. Compared with participants without any disease, those with stroke and diabetes had higher age- and sex-adjusted HRs for all-cause mortality (HR 3.9; 95% CI, 3.28-4.56). Moreover, the age- and sex-adjusted HRs for CVD mortality were highest in participants with stroke, ischemic heart disease, and diabetes (HR 10.6; 95% CI, 6.16-18.25). These patterns remained consistent after additional adjustments for smoking status and body mass index. The risk of premature mortality followed similar trends but was more pronounced.
These findings highlight the differential impacts of individual cardiometabolic diseases and their combinations on mortality risks. Stroke and diabetes were associated with the highest risks for all-cause and cardiovascular mortality, underscoring the need for targeted prevention and personalized management strategies tailored to these high-risk conditions in Asian populations.
关于大样本人群中多种疾病共存与死亡率之间关联的研究主要在欧洲和北美人群中开展。本研究旨在确定亚洲队列联盟中心脏代谢性多种疾病共存与全因死亡率及心血管疾病（CVD）死亡率之间的关联。
在这项前瞻性队列研究中，进行了汇总分析，以评估来自11项亚洲队列研究的参与者中心脏代谢性疾病（高血压、糖尿病、缺血性心脏病和中风）、多种疾病共存与全因死亡率及CVD死亡率（包括过早死亡率）之间的关联。使用Cox比例风险回归估计风险比（HRs）和95%置信区间（CIs）。
共有483,532名参与者被随访了中位数为14.3年的时间。与无任何疾病的参与者相比，患有中风和糖尿病的参与者经年龄和性别调整后的全因死亡率HRs更高（HR 3.9；95% CI，3.28 - 4.56）。此外，患有中风、缺血性心脏病和糖尿病的参与者经年龄和性别调整后的CVD死亡率HRs最高（HR 10.6；95% CI，6.16 - 18.25）。在对吸烟状况和体重指数进行额外调整后，这些模式仍然一致。过早死亡风险遵循类似趋势，但更为明显。
这些发现凸显了个体心脏代谢性疾病及其组合对死亡风险的不同影响。中风和糖尿病与全因死亡率和心血管死亡率的最高风险相关，强调了针对亚洲人群中这些高危情况制定有针对性的预防和个性化管理策略的必要性。
