Longitudinal Impact of Metabolic Syndrome Evolution on Incident Chronic Disease Multimorbidity: A Cohort Study

Background Metabolic syndrome (MetS) has been associated with the development of chronic diseases, including cardiovascular disease (CVD), type 2 diabetes (T2D), and chronic kidney disease (CKD). However, the association of a longitudinal MetS evolution with the multimorbidity of these disease remains unclear. We aimed to investigate the impact of MetS evolution on incident chronic disease multimorbidity. Methods This prospective cohort study included 36,201 participants in the Kailuan cohort who were free of CVD, CKD, T2D before 2006–2010. MetS patterns was categorized according to the status of MetS obtained during the 2006 and 2010 surveys. The primary endpoint was chronic disease multimorbidity (suffering from at least 2 of CKD, CVD and DM), and secondary endpoints included CVD-T2D multimorbidity, CVD-CKD multimorbidity and T2D-CKD multimorbidity. Cox regression models were used to assess the association of MetS evolution with chronic disease multimorbidity and its components. Results During a median follow-up of 12.02 years, 930 participants developed chronic disease multimorbidity. After considering potential confounders, the persistent metabolic disorder group (hazard ratio [HR], 2.95 [95% CI, 2.41–3.60]), the MetS recovery group (HR, 1.87 [95% CI, 1.48–2.36]), and the MetS progression group (HR, 1.70 [95% CI, 1.39–2.06]) were all associated with an elevated risk of chronic disease multimorbidity compare with the sustained metabolic health group. Generally similar results were observed in CVD-T2D multimorbidity, CVD-CKD multimorbidity and T2D-CKD multimorbidity, and the analysis of single diseases complements our conclusions. Conclusions Not only the current presence of MetS, but also a history of metabolic disorders, even in the absence of current MetS, may increase the risk of chronic disease multimorbidity. The findings emphasize the need for primary prevention of MetS and intervention in individuals with a history of MetS in order to halt further progression to chronic disease and the multimorbidity.