Lifestyle and clinical factors as predictive indicators of cardiometabolic multimorbidity in Chinese adults: Baseline findings of the Beijing Health Management Cohort (BHMC) study

Cardiometabolic multimorbidity (CMM) is increasing globally as a result of lifestyle changes and the aging population. Even though previous studies have examined risk factors associated with CMM, there is a shortage of prediction models that can accurately identify high-risk individuals for early prevention. In the baseline survey of the Beijing Health Management Cohort, a total of 77,752 adults aged 18 years or older were recruited from 2020 to 2021. Data on lifestyle factors, clinical profiles, and diagnoses of diabetes, coronary heart disease, and stroke were collected. Logistic regression models were used to identify risk factors for CMM. Nomograms were developed to estimate an individual's probability of CMM based on the identified risk factors. The performance of the model was evaluated using the area under the receiver operating characteristic curve (AUC). In men, the top three risk factors for CMM were hypertension (OR: 3.52, 95 % CI: 2.97–4.18), eating very fast (3.43, 2.27–5.16), and dyslipidemia (2.59, 2.20–3.06). In women, hypertension showed the strongest association with CMM (3.62, 2.90–4.52), followed by night sleep duration less than 5 h per day (2.41, 1.67–3.50) and dyslipidemia (1.91, 1.58–2.32). The ORs for holding passive and depressed psychological traits were 1.49 (95%CI: 1.08–2.06) in men and 1.58 (1.03–2.43) in women. Prediction models incorporating these factors demonstrated good discrimination in the test set, with AUC 0.84 (0.83–0.86) for men and 0.90 (0.89–0.91) for women. The sex-specific nomograms were established based on selected predictors. Modifiable lifestyle factors, metabolic health and psychological trait are associated with the risk of CMM. The developed prediction models and nomograms could facilitate early identification of individuals at high-risk of CMM.