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Familial aggregation of multimorbidity in Sweden: national explorative family study

OBJECTIVES: To examine whether multimorbidity aggregates in families in Sweden. DESIGN: National explorative family study. SETTING: Swedish Multigeneration Register linked to the National Patient Register, 1997-2015. Multimorbidity was assessed with a modified counting method of 45 chronic non-commu...

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Autores principales: Zöller, Bengt, Pirouzifard, MirNabi, Holmquist, Björn, Sundquist, Jan, Halling, Anders, Sundquist, Kristina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351236/
https://www.ncbi.nlm.nih.gov/pubmed/37465436
http://dx.doi.org/10.1136/bmjmed-2021-000070
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author Zöller, Bengt
Pirouzifard, MirNabi
Holmquist, Björn
Sundquist, Jan
Halling, Anders
Sundquist, Kristina
author_facet Zöller, Bengt
Pirouzifard, MirNabi
Holmquist, Björn
Sundquist, Jan
Halling, Anders
Sundquist, Kristina
author_sort Zöller, Bengt
collection PubMed
description OBJECTIVES: To examine whether multimorbidity aggregates in families in Sweden. DESIGN: National explorative family study. SETTING: Swedish Multigeneration Register linked to the National Patient Register, 1997-2015. Multimorbidity was assessed with a modified counting method of 45 chronic non-communicable diseases according to ICD-10 (international classification of diseases, 10th revision) diagnoses. PARTICIPANTS: 2 694 442 Swedish born individuals (48.73% women) who could be linked to their Swedish born first, second, and third degree relatives. Twins were defined as full siblings born on the same date. MAIN OUTCOME MEASURES: Multimorbidity was defined as two or more non-communicable diseases. Familial associations for one, two, three, four, and five or more non-communicable diseases were assessed to examine risks depending on the number of non-communicable diseases. Familial adjusted odds ratios for multimorbidity were calculated for individuals with a diagnosis of multimorbidity compared with relatives of individuals unaffected by multimorbidity (reference). An initial principal component decomposition followed by a factor analysis with a principal factor method and an oblique promax rotation was used on the correlation matrix of tetrachoric correlations between 45 diagnoses in patients to identify disease clusters. RESULTS: The odds ratios for multimorbidity were 2.89 in twins (95% confidence interval 2.56 to 3.25), 1.81 in full siblings (1.78 to 1.84), 1.26 in half siblings (1.24 to 1.28), and 1.13 in cousins (1.12 to 1.14) of relatives with a diagnosis of multimorbidity. The odds ratios for multimorbidity increased with the number of diseases in relatives. For example, among twins, the odds ratios for multimorbidity were 1.73, 2.84, 4.09, 4.63, and 6.66 for an increasing number of diseases in relatives, from one to five or more, respectively. Odds ratios were highest at younger ages: in twins, the odds ratio was 3.22 for those aged ≤20 years, 3.14 for those aged 21-30 years, and 2.29 for those aged >30 years at the end of follow-up. Nine disease clusters (factor clusters 1-9) were identified, of which seven aggregated in families. The first three disease clusters in the principal component decomposition were cardiometabolic disease (factor 1), mental health disorders (factor 2), and disorders of the digestive system (factor 3). Odds ratios for multimorbidity in twins, siblings, half siblings, and cousins for the factor 1 cluster were 2.79 (95% confidence interval 0.97 to 8.06), 2.62 (2.39 to 2.88), 1.52 (1.34 to 1.73), and 1.31 (1.23 to 1.39), and for the factor 2 cluster, 5.79 (4.48 to 7.48) 3.24 (3.13 to 3.36), 1.51 (1.45 to 1.57), and 1.37 (1.341.40). CONCLUSIONS: The results of this explorative family study indicated that multimorbidity aggregated in Swedish families. The findings suggest that map clusters of diseases should be used for the genetic study of common diseases to show new genetic patterns of non-communicable diseases.
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spelling pubmed-103512362023-07-18 Familial aggregation of multimorbidity in Sweden: national explorative family study Zöller, Bengt Pirouzifard, MirNabi Holmquist, Björn Sundquist, Jan Halling, Anders Sundquist, Kristina BMJ Med Research OBJECTIVES: To examine whether multimorbidity aggregates in families in Sweden. DESIGN: National explorative family study. SETTING: Swedish Multigeneration Register linked to the National Patient Register, 1997-2015. Multimorbidity was assessed with a modified counting method of 45 chronic non-communicable diseases according to ICD-10 (international classification of diseases, 10th revision) diagnoses. PARTICIPANTS: 2 694 442 Swedish born individuals (48.73% women) who could be linked to their Swedish born first, second, and third degree relatives. Twins were defined as full siblings born on the same date. MAIN OUTCOME MEASURES: Multimorbidity was defined as two or more non-communicable diseases. Familial associations for one, two, three, four, and five or more non-communicable diseases were assessed to examine risks depending on the number of non-communicable diseases. Familial adjusted odds ratios for multimorbidity were calculated for individuals with a diagnosis of multimorbidity compared with relatives of individuals unaffected by multimorbidity (reference). An initial principal component decomposition followed by a factor analysis with a principal factor method and an oblique promax rotation was used on the correlation matrix of tetrachoric correlations between 45 diagnoses in patients to identify disease clusters. RESULTS: The odds ratios for multimorbidity were 2.89 in twins (95% confidence interval 2.56 to 3.25), 1.81 in full siblings (1.78 to 1.84), 1.26 in half siblings (1.24 to 1.28), and 1.13 in cousins (1.12 to 1.14) of relatives with a diagnosis of multimorbidity. The odds ratios for multimorbidity increased with the number of diseases in relatives. For example, among twins, the odds ratios for multimorbidity were 1.73, 2.84, 4.09, 4.63, and 6.66 for an increasing number of diseases in relatives, from one to five or more, respectively. Odds ratios were highest at younger ages: in twins, the odds ratio was 3.22 for those aged ≤20 years, 3.14 for those aged 21-30 years, and 2.29 for those aged >30 years at the end of follow-up. Nine disease clusters (factor clusters 1-9) were identified, of which seven aggregated in families. The first three disease clusters in the principal component decomposition were cardiometabolic disease (factor 1), mental health disorders (factor 2), and disorders of the digestive system (factor 3). Odds ratios for multimorbidity in twins, siblings, half siblings, and cousins for the factor 1 cluster were 2.79 (95% confidence interval 0.97 to 8.06), 2.62 (2.39 to 2.88), 1.52 (1.34 to 1.73), and 1.31 (1.23 to 1.39), and for the factor 2 cluster, 5.79 (4.48 to 7.48) 3.24 (3.13 to 3.36), 1.51 (1.45 to 1.57), and 1.37 (1.341.40). CONCLUSIONS: The results of this explorative family study indicated that multimorbidity aggregated in Swedish families. The findings suggest that map clusters of diseases should be used for the genetic study of common diseases to show new genetic patterns of non-communicable diseases. BMJ Publishing Group 2023-07-14 /pmc/articles/PMC10351236/ /pubmed/37465436 http://dx.doi.org/10.1136/bmjmed-2021-000070 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Research
Zöller, Bengt
Pirouzifard, MirNabi
Holmquist, Björn
Sundquist, Jan
Halling, Anders
Sundquist, Kristina
Familial aggregation of multimorbidity in Sweden: national explorative family study
title Familial aggregation of multimorbidity in Sweden: national explorative family study
title_full Familial aggregation of multimorbidity in Sweden: national explorative family study
title_fullStr Familial aggregation of multimorbidity in Sweden: national explorative family study
title_full_unstemmed Familial aggregation of multimorbidity in Sweden: national explorative family study
title_short Familial aggregation of multimorbidity in Sweden: national explorative family study
title_sort familial aggregation of multimorbidity in sweden: national explorative family study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351236/
https://www.ncbi.nlm.nih.gov/pubmed/37465436
http://dx.doi.org/10.1136/bmjmed-2021-000070
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