Latest news with #multimorbidity
Medscape
3 days ago
- Health
- Medscape
MASLD Patients Have More Comorbidities, Higher Death Risk
A higher burden of multimorbidity was seen in patients with metabolic dysfunction‐associated steatotic liver disease (MASLD) than in individuals without MASLD, with a higher risk for all-cause mortality observed in those with MASLD and multimorbidity. METHODOLOGY: In this large UK-based study, researchers determined the prevalence of multimorbidity in individuals with MASLD and assessed how MASLD, alongside the extent of multimorbidity, affects all-cause mortality. The analysis included data of 438,840 participants (mean age, 56.5 years; 42.2% men) from the UK Biobank who were recruited between 2006 and 2010. The diagnosis of MASLD was confirmed if patients had liver steatosis (fatty liver index ≥ 60%), at least one cardiometabolic risk factor, and low alcohol consumption. Overall, 47 long-term conditions were considered, including extrahepatic cancers; cardiovascular, metabolic, and endocrine disorders; and respiratory, digestive, renal, mental health, and congenital conditions. Multimorbidity was defined as having more than two of these long-term conditions. The outcome was all-cause mortality, assessed over a median follow-up duration of 13 years. TAKEAWAY: At baseline, 29.9% of participants had MASLD, with a higher prevalence of multimorbidity than that in those without MASLD (21.3% vs 14.4%). MASLD was associated with an increased risk for all-cause mortality (adjusted hazard ratio [aHR], 1.16; 95% CI, 1.13-1.19), with stronger effects seen in women (aHR, 1.25; 95% CI, 1.20-1.29) than in men (aHR, 1.10; 95% CI, 1.07-1.13). Patients with MASLD were more likely to have 32 out of the 47 long-term conditions. Each additional long-term condition increased the risk for mortality by 30% in patients with MASLD (aHR, 1.30; 95% CI, 1.29-1.31) and by 38% in individuals without MASLD (aHR, 1.38; 95% CI, 1.37-1.40). The most prevalent cardiometabolic risk factor in patients with MASLD was obesity (98.9%), and among all long-term conditions, Parkinson's disease showed the highest risk for mortality in those with MASLD (aHR, 6.09; 95% CI, 4.47-8.29). IN PRACTICE: "Addressing multimorbidity in MASLD patients through multidisciplinary and proactive management of multimorbidity is crucial to improving patient outcomes and reducing the overall public health impact of MASLD," the authors of the study wrote. SOURCE: This study was led by Qi Feng, The George Institute for Global Health (UK), School of Public Health, Faculty of Medicine, Imperial College London, London, England. It was published online on June 10, 2025, in The Journal of Clinical Endocrinology and Metabolism . LIMITATIONS: The predominantly White, more affluent UK Biobank cohort may not have reflected the wider UK population, further limiting the generalisability of the findings to other populations. Reliance on self-reported lifestyle data covering physical activity, smoking, and alcohol consumption may have led to information bias, potentially resulting in the misclassification of MASLD vs alcohol-related liver disease. DISCLOSURES: This study was supported by the National Institute for Health and Care Research Imperial Biomedical Research Centre. The authors reported having no conflicts of interest.
Medscape
12-05-2025
- Health
- Medscape
Multiple Comorbidities Can Have Big Impact on SSc Outcomes
In a cohort of 2000 patients with systemic sclerosis (SSc), 20% were found to have multimorbidity, primarily driven by cardiovascular disease and other important cardiovascular risk factors. The presence of multimorbidity was linked to reduced survival rates and impaired physical function. METHODOLOGY: Researchers aimed to determine the frequency and prognostic impact of multimorbidity in 2000 patients with SSc (median age at SSc onset , 47.4 years; 85.4% women) from the Australian Scleroderma Cohort Study. Charlson Comorbidity Index (CCI) scores were calculated at each visit for all participants, with multimorbidity defined as having a CCI score of ≥ 4. Health Assessment Questionnaire Disability Index scores were collected every year during study visits, whereas data on demographics, disease, and medication use were collected at each visit. The median duration of SSc at recruitment was 7.1 years, and the median follow-up duration was 4.2 years. TAKEAWAY: During the follow-up period, multimorbidity was observed in 20.1% of participants at a median of 12 years after the onset of SSc; the key comorbidities were hypertension (80.5%), dyslipidemia (67.2%), obstructive lung disease (50.4%), malignancy (48.9%), and ischemic heart disease (40.1%). The presence of multimorbidity increased the risk for death by 57% (hazard ratio [HR], 1.57; P < .01), with chronic kidney disease showing the strongest association with mortality (HR, 2.41; P < .01), followed by left ventricular dysfunction (HR, 1.76; P < .01). < .01), with chronic kidney disease showing the strongest association with mortality (HR, 2.41; < .01), followed by left ventricular dysfunction (HR, 1.76; < .01). Having multimorbidity was also associated with poorer physical function ( P < .01), with peripheral vascular disease having the largest impact on physical function, followed by left ventricular dysfunction. IN PRACTICE: 'These data suggest a role for aggressive management of comorbid cardiac and renal disease to potentially improve outcomes in SSc,' the authors wrote. SOURCE: This study was led by Jessica L. Fairley, MBBS, The University of Melbourne and St Vincent's Hospital Melbourne, both in Melbourne, Australia. It was published online on April 21, 2025, in ACR Open Rheumatology . LIMITATIONS: The CCI was modified for application to the database as not all variables were available for analysis, including depression, cellulitis, liver disease, peptic ulcer disease, hemiplegia, HIV/AIDS, and dementia. This likely resulted in underestimating the frequency of multimorbidity in the cohort. Additionally, the Australian Scleroderma Cohort Study exhibits a degree of survivor bias, where more severely ill individuals may not survive to recruitment. DISCLOSURES: The Australian Scleroderma Cohort Study was supported by Janssen, Boehringer Ingelheim, Scleroderma Australia, and other sources. Some authors reported receiving grants, payments, honoraria, consulting fees, and travel support from, and having other ties with various pharmaceutical companies including the funding agencies.
