ASSOCIATION BETWEEN SYSTEMIC INFLAMMATORY BIOMARKERS AND THE RISK OF MULTIMORBIDITY IN PATIENTS WITH NON-COMMUNICABLE DISEASES: A CROSS-SECTIONAL STUDY
ABSTRACT
Background: Multimorbidity, the coexistence of two or more chronic non-communicable diseases (NCDs), is increasing globally and is strongly associated with adverse clinical outcomes. Systemic inflammation is considered a potential shared biological mechanism underlying multimorbidity; however, evidence from clinical populations remains limited. The objective of the study is to evaluate the association between systemic inflammatory biomarkers and multimorbidity among patients with NCDs in a hospital-based cross-sectional study.
Materials and Methods: A cross-sectional study was conducted among adult patients (≥18 years) with diagnosed NCDs. Multimorbidity was defined as the presence of ≥2 chronic conditions. Data on sociodemographic and clinical variables were collected using structured questionnaires and medical records. Serum levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), fibrinogen, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were measured using standard laboratory methods. Statistical analyses included group comparisons, correlation analysis, multivariable logistic regression, and ROC curve analysis.
Result: Patients with multimorbidity showed significantly higher levels of all inflammatory biomarkers compared to those with a single NCD (p<0.001). IL-6 demonstrated the strongest correlation with multimorbidity burden (r=0.58, p<0.001). After adjustment for confounders, IL-6 (AOR=3.84, 95% CI: 2.31–6.37) and hs-CRP (AOR=3.29, 95% CI: 2.01–5.39) were independent predictors of multimorbidity. The combined biomarker model showed high discriminatory performance (AUC=0.903).
Conclusion: Systemic inflammatory biomarkers, particularly IL-6 and hs-CRP, are strongly associated with multimorbidity among patients with NCDs. These biomarkers may serve as useful tools for risk stratification and early identification of individuals at high risk of complex disease burden.
Keywords: Multimorbidity, Non-communicable diseases, Systemic inflammation, IL-6; hs-CRP, Biomarkers, Cross-sectional study.
Background: Multimorbidity, the coexistence of two or more chronic non-communicable diseases (NCDs), is increasing globally and is strongly associated with adverse clinical outcomes. Systemic inflammation is considered a potential shared biological mechanism underlying multimorbidity; however, evidence from clinical populations remains limited. The objective of the study is to evaluate the association between systemic inflammatory biomarkers and multimorbidity among patients with NCDs in a hospital-based cross-sectional study.
Materials and Methods: A cross-sectional study was conducted among adult patients (≥18 years) with diagnosed NCDs. Multimorbidity was defined as the presence of ≥2 chronic conditions. Data on sociodemographic and clinical variables were collected using structured questionnaires and medical records. Serum levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), fibrinogen, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were measured using standard laboratory methods. Statistical analyses included group comparisons, correlation analysis, multivariable logistic regression, and ROC curve analysis.
Result: Patients with multimorbidity showed significantly higher levels of all inflammatory biomarkers compared to those with a single NCD (p<0.001). IL-6 demonstrated the strongest correlation with multimorbidity burden (r=0.58, p<0.001). After adjustment for confounders, IL-6 (AOR=3.84, 95% CI: 2.31–6.37) and hs-CRP (AOR=3.29, 95% CI: 2.01–5.39) were independent predictors of multimorbidity. The combined biomarker model showed high discriminatory performance (AUC=0.903).
Conclusion: Systemic inflammatory biomarkers, particularly IL-6 and hs-CRP, are strongly associated with multimorbidity among patients with NCDs. These biomarkers may serve as useful tools for risk stratification and early identification of individuals at high risk of complex disease burden.
Keywords: Multimorbidity, Non-communicable diseases, Systemic inflammation, IL-6; hs-CRP, Biomarkers, Cross-sectional study.
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