Elevated cumulative lipid-inflammatory indices are independently and positively associated with a higher risk of incident cardiometabolic multimorbidity in a dose-response manner, and incorporating these indices into conventional risk models improved risk reclassification and discriminatory ability.
Key Findings
Results
All nine cumulative lipid-inflammatory indices were independently and positively associated with an elevated risk of cardiometabolic multimorbidity in a dose-response manner.
25,376 participants from the Kailuan cohort were included and followed until December 31, 2023
Median follow-up was 13.0 years
481 incident CMM events were documented during follow-up
Nine cumulative lipid-inflammatory exposure indices were constructed via trapezoidal area-under-the-curve calculation using repeated measurements from 2006 to 2010
Multivariable Cox regression and restricted cubic spline analyses were used to assess associations and dose-response relationships
Results
Cumulative lipid-inflammatory indices improved risk reclassification and discriminatory ability when incorporated into conventional risk models.
Adding the nine cumulative lipid-inflammatory indices to the conventional risk model improved both risk reclassification and discriminatory ability
These composite markers were proposed as auxiliary indicators for preliminary risk stratification
The improvement was assessed in the context of a prospective cohort design with competing-risk models and subgroup analyses also applied
Methods
Cardiometabolic multimorbidity (CMM) was defined as the concurrence of at least two cardiometabolic diseases, including type 2 diabetes, ischemic heart disease, and stroke.
CMM was the primary outcome of the study
Three specific cardiometabolic conditions were included: type 2 diabetes, ischemic heart disease, and stroke
481 incident CMM events were identified over a median 13.0 years of follow-up among 25,376 participants
Methods
Cumulative lipid-inflammatory indices were constructed from repeated measurements to capture long-term combined exposure to dyslipidemia and chronic low-grade inflammation.
Nine distinct cumulative indices were constructed
Indices were derived using trapezoidal area-under-the-curve calculations
Repeated measurements were taken from 2006 to 2010 to capture cumulative exposure over time
The approach was designed to assess long-term combined effects of dyslipidemia and chronic low-grade inflammation, which had been poorly understood previously
Results
The associations between cumulative lipid-inflammatory indices and CMM risk were confirmed under competing-risk models and across subgroup analyses.
Competing-risk models were applied in addition to multivariable Cox regression to account for competing events
Subgroup analyses were also conducted to assess consistency of associations
Restricted cubic spline analyses confirmed dose-response relationships between the indices and CMM risk
The authors noted that causal relationships cannot be confirmed based on this observational cohort alone
What This Means
This research suggests that people with higher long-term levels of combined blood fat (lipid) and inflammation markers face a substantially greater risk of developing cardiometabolic multimorbidity — meaning having two or more serious conditions such as type 2 diabetes, heart disease, or stroke at the same time. The researchers followed over 25,000 adults in China for about 13 years and calculated nine different 'combined lipid-inflammation scores' based on repeated blood measurements taken over several years, rather than just a single snapshot. All nine of these cumulative scores were linked to a higher chance of developing multiple cardiometabolic diseases, and the more elevated the scores, the greater the risk.
The study also found that adding these combined scores to standard medical risk assessments improved doctors' ability to identify who is more likely to develop these conditions in the future. This suggests that tracking both lipid levels and inflammation markers together over time — rather than measuring them separately or only once — may offer a more complete picture of a person's long-term cardiometabolic risk.
This research matters because cardiometabolic multimorbidity is a growing global health problem, and identifying people at higher risk earlier could allow for more targeted monitoring or preventive care. However, because this was an observational study, it cannot prove that high lipid-inflammatory scores directly cause these diseases — only that they are associated with higher risk. The findings also come from a specific Chinese cohort, so further research in other populations would be needed to confirm how broadly these results apply.
Meng L, Gao H, Yang J, Wu S, Chen S, Wu Y, et al.. (2026). Cumulative lipid-inflammatory indices and the risk of cardiometabolic multimorbidity: a prospective cohort study.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2026.1909025