Multimorbidity of non-communicable diseases in Chinese rural population: the Henan Rural Cohort Study (Preprint)

BACKGROUND Multimorbidity causes significant disease and economic burdens on both individuals and the healthcare system. OBJECTIVE This study aims to explore the disease burden of multimorbidity and the potential correlations among chronic non-communicable diseases (NCDs) in a Chinese rural population. METHODS A total of 38,807 participants from the Henan Rural Cohort Study were included in this study. Multimorbidity was defined as the simultaneous occurrence of at least two NCDs in a participant. This study examined the pattern of multimorbidity of six NCDs, including hypertension, dyslipidemia, type 2 diabetes mellitus (T2DM), coronary heart disease (CHD), stroke, and hyperuricemia. RESULTS The overall population prevalence of multimorbidity was 28.08%, and the clustering of hypertension and dyslipidemia was the most common (8.12%). Aging, higher BMI, and unfavourable lifestyles significantly increased the risk of multimorbidity (multinomial logistic regression, all p<0.05). Analysis of the mean age at diagnosis demonstrated a cascade of inter-related NCDs and their accumulation over age. Participants with one conditional NCD would incur an elevated risk of developing another NCD than otherwise. Similarly, participants with two conditional NCDs would incur an even higher risk of developing the third NCD than participants without both NCDs (binary logistic regression, all p<0.05). CONCLUSIONS Our findings demonstrate a strong tendency for coexistence and accumulation of NCDs in a Chinese rural population. Early prevention of multimorbidity is essential to reduce the NCD burden in the rural population. CLINICALTRIAL The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-07-06. http://www.chictr.org.cn/showproj.aspx?proj=11375