Burden of Non-Communicable Diseases Attributable to Polygenic Risk and Its Association with Healthcare Utilization in Taiwan
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Background
Non-communicable diseases (NCDs) impose substantial population burden. Their polygenic architecture informs early risk stratification through polygenic risk scores (PRS). Previous studies reported elevated-PRS burden comparable to some modifiable risk factors (MRFs), yet evidence remains confined to European populations. We quantified the PRS-attributable NCD burden in Taiwan.
Methods
Linking Taiwan Biobank and National Health Insurance Research Database (N ≈ 140K), we analyzed 42 high-burden NCDs. Elevated genetic risk ( PRS e ; top 10%) was assessed using Cox models. We estimated population attributable fractions (PAFs) and disability-adjusted life years (DALYs) using Taiwan-specific estimates from Global Burden of Disease 2023, and examined associations between an integrated PRS (iPRS) and healthcare utilization.
Findings
Strongest PRS e associations occurred for atrial fibrillation (AFib; HR = 3.56 [95% CI: 3.23-3.92]) and gout (2.41 [2.33-2.49]), yielding PAFs of 20% and 12%, respectively, while population-level attributable DALYs were largest for type 2 diabetes (T2D), intracranial hemorrhage (ICH), and lung cancer. At the individual level, PRS e corresponded to 1.50 [1.42-1.57] healthy life-years lost for T2D and 0.57 [0.40-0.76] for ICH, approaching 2.4 years for the top 1% PRS. Polygenic attributable burden was overall greater in men. For several diseases, PRS e -associated PAF and DALYs exceeded those of individual MRFs (e.g., smoking, alcohol use). Top-decile iPRS was linked to 23.9% (15.0-33.6%) more hospital days, 19.1% (13.2-25.3%) more inpatient visits, and 9.6% (6.9-12.4%) more outpatient visits.
Interpretation
Polygenic risk accounts for a measurable—and for several diseases, MRF-comparable—share of NCD burden in Taiwan, providing a quantitative foundation for integrating genetic liability into preventive care and health planning.
Funding
National Taiwan University Academic Research-Career Development Project, Yushan Young Fellow Program from the Ministry of Education (MoE), and the Population Health Research Center from Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the MoE in Taiwan.
