International journal of public health · 2026
Multimodal risk profiles reveal shared and disease-specific risks of major non-communicable diseases: a prospective cohort study of 42,666 individuals.
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Xu Qiaoyi, Liu Zhenqiu, Zhao Renjia, Cui Zixuan, Xing Xufei, Chen Xingdong, Suo Chen
Аннотация
OBJECTIVES: Evaluate whether circulating blood biomarker profiles identify shared and disease-specific risks of non-communicable diseases (NCDs).
METHODS: We considered 42,666 participants from Taizhou, China. After exclusions, discovery (n = 14,478; recruited 2011.9-2014.1) and temporal validation (n = 25,018; recruited 2018.7-2021.11) cohorts were defined. We integrated 54 blood biomarkers and 26 questionnaire/physical indicators. Predictors were selected after Cox pre-screening based on concordant inclusion across stepwise regression, regularized regression, and Boruta random forest.
RESULTS: The final score included 15 biomarkers plus age, smoking, hypertension, and vegetable intake. In the temporal validation cohort, high-risk individuals (25.0% of participants) accounted for 53.9% of incident major NCD cases, with a 6.29-fold (4.83-8.19) higher risk than the low-risk group. Similar gradients were observed for all-cause mortality. Compared with disease-specific scores, the combined score effectively stratified both composite and individual outcomes and revealed shared risks: 56.1% of disease-specific high-risk individuals were also high risk for other NCDs.
CONCLUSION: A score integrating blood biomarkers with epidemiological and physical measures achieved clear risk stratification in the temporal validation cohort and may support priority population identification for major NCDs.
METHODS: We considered 42,666 participants from Taizhou, China. After exclusions, discovery (n = 14,478; recruited 2011.9-2014.1) and temporal validation (n = 25,018; recruited 2018.7-2021.11) cohorts were defined. We integrated 54 blood biomarkers and 26 questionnaire/physical indicators. Predictors were selected after Cox pre-screening based on concordant inclusion across stepwise regression, regularized regression, and Boruta random forest.
RESULTS: The final score included 15 biomarkers plus age, smoking, hypertension, and vegetable intake. In the temporal validation cohort, high-risk individuals (25.0% of participants) accounted for 53.9% of incident major NCD cases, with a 6.29-fold (4.83-8.19) higher risk than the low-risk group. Similar gradients were observed for all-cause mortality. Compared with disease-specific scores, the combined score effectively stratified both composite and individual outcomes and revealed shared risks: 56.1% of disease-specific high-risk individuals were also high risk for other NCDs.
CONCLUSION: A score integrating blood biomarkers with epidemiological and physical measures achieved clear risk stratification in the temporal validation cohort and may support priority population identification for major NCDs.