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Approved Research

Development and validation of predictive multimorbidity model through genetic and healthy lifestyle and explore causal risk factors of multimorbidity and the effect of multimorbidity on mortality

Principal Investigator: Professor Bo Zhang
Approved Research ID: 98577
Approval date: May 9th 2023

Lay summary

Multimorbidity, commonly defined as the coexistence of two or more chronic conditions, is becoming an increasing trend worldwide. Despite projects that the number of people living with multimorbidity will continue to increase, research remains focused on a single disease. Some studies had showed that some risk factors, such as obesity, smoking status, socioeconomic status, and healthy lifestyle, were associated with multimorbidity, however, it is unclear that the cause risk factors of multimorbidity helped to understand the mechanism of multimorbidity. The prevenance of multimorbidity was increasing with aging, however, multimorbidity often occurs in younger people in recent years. Multimorbidity, and particularly how to better prevent the accumulation of multiple diseases, has received much less attention. What's more, the relationship between multimorbidity and mortality in different diabetes/prediabetes subgroups is unclear.

Our research projects on the development and validation of predictive complex multimorbidity models in the UK biobank, and explore the causal risk factors of complex multimorbidity, and explore the relationship between multimorbidity and mortality. The research projects contribute to the realization of precision prevention of participants for multimorbidity disease. Meanwhile, it will help to understand the mechanism of these complex multimorbidity and the relationship between multimorbidity and mortality. The project duration for this application is 36 months. We are looking forward to getting the approval of this study, hoping to contribute to the prevention and understanding of multimorbidity to improve public health.

Scope extension, June 2024: 

The prevalence of chronic multimorbidity (including metabolic syndrome, nonalcoholic fatty liver, diabetes mellitus, cardiovascular disease, and cancer) is increasing rapidly. Considerable evidence exists about the predictive model of having any 1 of these conditions alone. However, evidence is sparse about the predictive multimorbidity model. What's more, understanding the determinants of multimorbidity may help with the design and prioritization of interventions to prevent multimorbidity. It is very necessary to explore the potential causal determinants of multimorbidity. Evidence is rare about mortality among people who have 2 or 3 coexisting conditions in early-onset or late-onset diabetes/ prediabetes. Hence, our research aims are:

(1) Using genetic information, healthy lifestyle, and clinical measurements to develop and validate the risk equation of chronic multimorbidity.

(2) Explore the causal risk factors of multimorbidity.

(3) We quantified the association of multimorbidity with all-cause mortality in early-onset or late-onset diabetes/ prediabetes.

In the results of our multimorbidity study using UK Biobank, we found that metabolic abnormalities (including diabetes, hypertension, dyslipidemia, obesity, insulin resistance) are important factors affecting multimorbidity. However, it is unclear that metabolic abnormalities on single disease (respiratory, blood, digestive, cardiovascular, cerebrovascular, and neurological diseases). Therefore, the aim of our research is to explore the effects of metabolic abnormalities on single disease and to explore the effect of related genes of metabolic abnormalities on single disease.