A wide landscape of morbidity and mortality risk associated with marital status in 0.5 million Chinese men and women : a prospective cohort study
© 2023 The Authors..
Background: A comprehensive depiction of long-term health impacts of marital status is lacking.
Methods: Sex-stratified phenome-wide association analyses (PheWAS) of marital status (living with vs. without a spouse) were performed using baseline (2004-2008) and follow-up information (ICD10-coded events till Dec 31, 2017) from the China Kadoorie Biobank (CKB). We estimated adjusted hazard ratios (aHRs) to evaluate the associations of marital status with morbidity risks of phenome-wide significant diseases or sex-specific top-10 death causes in China documented in 2017. Additionally, the association between marital status and mortality risks among participants with major chronic diseases at baseline was assessed.
Findings: During up to 11.1 years of the median follow-up period, 1,946,380 incident health events were recorded among 210,202 men and 302,521 women aged 30-79. Marital status was found to have phenome-wide significant associations with thirteen diseases among men (p < 9.92 × 10-5) and nine diseases among women (p < 9.33 × 10-5), respectively. After adjusting for all disease-specific covariates in the final model, participants living without a spouse showed increased risks of schizophrenia, schizotypal and delusional disorders (aHR [95% CI]: 2.55, [1.83-3.56] for men; 1.49, [1.13-1.97] for women) compared with their counterparts. Additional higher risks in overall mental and behavioural disorder (1.31, 1.13-1.53), cardiovascular disease (1.07, 1.04-1.10) and cancer (1.06, 1.00-1.12) were only observed among men without a spouse, whereas women living without a spouse were at lower risks of developing genitourinary diseases (0.89, 0.85-0.93) and injury & poisoning (0.93, 0.88-0.97). Among 282,810 participants with major chronic diseases at baseline, 39,166 deaths were recorded. Increased mortality risks for those without a spouse were observed in 12 of 21 diseases among male patients and one of 23 among female patients. For patients with any self-reported disease at baseline, compared with those living with a spouse, the aHRs (95% CIs) of mortality risk were 1.29 (1.24-1.34) and 1.04 (1.00-1.07) among men and women without a spouse (pinteraction<0.0001), respectively.
Interpretation: Long-term associations of marital status with morbidity and mortality risks are diverse among middle-aged Chinese adults, and the adverse impacts due to living without a spouse are more profound among men. Marital status may be an influential factor for health needs.
Funding: The National Natural Science Foundation of China, the Kadoorie Charitable Foundation, the National Key R&D Program of China, the Chinese Ministry of Science and Technology, and the UK Wellcome Trust.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:42 |
|---|---|
| Enthalten in: |
The Lancet regional health. Western Pacific - 42(2024) vom: 08. Jan., Seite 100948 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Xiao, Meng [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Chinese |
|---|
| Anmerkungen: |
Date Revised 16.02.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1016/j.lanwpc.2023.100948 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM368474984 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM368474984 | ||
| 003 | DE-627 | ||
| 005 | 20240216232855.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240215s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.lanwpc.2023.100948 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1296.xml |
| 035 | |a (DE-627)NLM368474984 | ||
| 035 | |a (NLM)38357394 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Xiao, Meng |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A wide landscape of morbidity and mortality risk associated with marital status in 0.5 million Chinese men and women |b a prospective cohort study |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 16.02.2024 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2023 The Authors. | ||
| 520 | |a Background: A comprehensive depiction of long-term health impacts of marital status is lacking | ||
| 520 | |a Methods: Sex-stratified phenome-wide association analyses (PheWAS) of marital status (living with vs. without a spouse) were performed using baseline (2004-2008) and follow-up information (ICD10-coded events till Dec 31, 2017) from the China Kadoorie Biobank (CKB). We estimated adjusted hazard ratios (aHRs) to evaluate the associations of marital status with morbidity risks of phenome-wide significant diseases or sex-specific top-10 death causes in China documented in 2017. Additionally, the association between marital status and mortality risks among participants with major chronic diseases at baseline was assessed | ||
| 520 | |a Findings: During up to 11.1 years of the median follow-up period, 1,946,380 incident health events were recorded among 210,202 men and 302,521 women aged 30-79. Marital status was found to have phenome-wide significant associations with thirteen diseases among men (p < 9.92 × 10-5) and nine diseases among women (p < 9.33 × 10-5), respectively. After adjusting for all disease-specific covariates in the final model, participants living without a spouse showed increased risks of schizophrenia, schizotypal and delusional disorders (aHR [95% CI]: 2.55, [1.83-3.56] for men; 1.49, [1.13-1.97] for women) compared with their counterparts. Additional higher risks in overall mental and behavioural disorder (1.31, 1.13-1.53), cardiovascular disease (1.07, 1.04-1.10) and cancer (1.06, 1.00-1.12) were only observed among men without a spouse, whereas women living without a spouse were at lower risks of developing genitourinary diseases (0.89, 0.85-0.93) and injury & poisoning (0.93, 0.88-0.97). Among 282,810 participants with major chronic diseases at baseline, 39,166 deaths were recorded. Increased mortality risks for those without a spouse were observed in 12 of 21 diseases among male patients and one of 23 among female patients. For patients with any self-reported disease at baseline, compared with those living with a spouse, the aHRs (95% CIs) of mortality risk were 1.29 (1.24-1.34) and 1.04 (1.00-1.07) among men and women without a spouse (pinteraction<0.0001), respectively | ||
| 520 | |a Interpretation: Long-term associations of marital status with morbidity and mortality risks are diverse among middle-aged Chinese adults, and the adverse impacts due to living without a spouse are more profound among men. Marital status may be an influential factor for health needs | ||
| 520 | |a Funding: The National Natural Science Foundation of China, the Kadoorie Charitable Foundation, the National Key R&D Program of China, the Chinese Ministry of Science and Technology, and the UK Wellcome Trust | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Chinese | |
| 650 | 4 | |a Marital status | |
| 650 | 4 | |a Morbidity risk | |
| 650 | 4 | |a Mortality risk | |
| 650 | 4 | |a Phenome-wide landscape | |
| 700 | 1 | |a Li, Aolin |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Yueqing |e verfasserin |4 aut | |
| 700 | 1 | |a Yu, Canqing |e verfasserin |4 aut | |
| 700 | 1 | |a Pang, Yuanjie |e verfasserin |4 aut | |
| 700 | 1 | |a Pei, Pei |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Ling |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Yiping |e verfasserin |4 aut | |
| 700 | 1 | |a Du, Huaidong |e verfasserin |4 aut | |
| 700 | 1 | |a Schmidt, Dan |e verfasserin |4 aut | |
| 700 | 1 | |a Avery, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Sun, Qiang |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Junshi |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Zhengming |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Liming |e verfasserin |4 aut | |
| 700 | 1 | |a Lv, Jun |e verfasserin |4 aut | |
| 700 | 1 | |a Sun, Dianjianyi |e verfasserin |4 aut | |
| 700 | 0 | |a China Kadoorie Biobank Collaborative Group |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Junshi |e investigator |4 oth | |
| 700 | 1 | |a Chen Pi, Zhengming |e investigator |4 oth | |
| 700 | 1 | |a Clarke, Robert |e investigator |4 oth | |
| 700 | 1 | |a Collins, Rory |e investigator |4 oth | |
| 700 | 1 | |a Guo, Yu |e investigator |4 oth | |
| 700 | 1 | |a Li Pi, Liming |e investigator |4 oth | |
| 700 | 1 | |a Lv, Jun |e investigator |4 oth | |
| 700 | 1 | |a Peto, Richard |e investigator |4 oth | |
| 700 | 1 | |a Walters, Robin |e investigator |4 oth | |
| 700 | 1 | |a Avery, Daniel |e investigator |4 oth | |
| 700 | 1 | |a Bennett, Derrick |e investigator |4 oth | |
| 700 | 1 | |a Boxall, Ruth |e investigator |4 oth | |
| 700 | 1 | |a Burgess, Sue |e investigator |4 oth | |
| 700 | 1 | |a Chan, Ka Hung |e investigator |4 oth | |
| 700 | 1 | |a Chang, Yumei |e investigator |4 oth | |
| 700 | 1 | |a Chen, Yiping |e investigator |4 oth | |
| 700 | 1 | |a Chen, Zhengming |e investigator |4 oth | |
| 700 | 1 | |a Clarke, Johnathan |e investigator |4 oth | |
| 700 | 1 | |a Clarke, Robert |e investigator |4 oth | |
| 700 | 1 | |a Du, Huaidong |e investigator |4 oth | |
| 700 | 1 | |a Mohamed, Ahmed Edris |e investigator |4 oth | |
| 700 | 1 | |a Fairhurst-Hunter, Zammy |e investigator |4 oth | |
| 700 | 1 | |a Fry, Hannah |e investigator |4 oth | |
| 700 | 1 | |a Hill, Mike |e investigator |4 oth | |
| 700 | 1 | |a Holmes, Michael |e investigator |4 oth | |
| 700 | 1 | |a Im, Pek Kei |e investigator |4 oth | |
| 700 | 1 | |a Iona, Andri |e investigator |4 oth | |
| 700 | 1 | |a Kakkoura, Maria |e investigator |4 oth | |
| 700 | 1 | |a Kartsonaki, Christiana |e investigator |4 oth | |
| 700 | 1 | |a Kerosi, Rene |e investigator |4 oth | |
| 700 | 1 | |a Lin, Kuang |e investigator |4 oth | |
| 700 | 1 | |a Mazidi, Mohsen |e investigator |4 oth | |
| 700 | 1 | |a Millwood, Iona |e investigator |4 oth | |
| 700 | 1 | |a Morris, Sam |e investigator |4 oth | |
| 700 | 1 | |a Nie, Qunhua |e investigator |4 oth | |
| 700 | 1 | |a Pozarickij, Alfred |e investigator |4 oth | |
| 700 | 1 | |a Ryder, Paul |e investigator |4 oth | |
| 700 | 1 | |a Said, Saredo |e investigator |4 oth | |
| 700 | 1 | |a Schmidt, Dan |e investigator |4 oth | |
| 700 | 1 | |a Sherliker, Paul |e investigator |4 oth | |
| 700 | 1 | |a Stevens, Becky |e investigator |4 oth | |
| 700 | 1 | |a Turnbull, Iain |e investigator |4 oth | |
| 700 | 1 | |a Walters, Robin |e investigator |4 oth | |
| 700 | 1 | |a Wang, Lin |e investigator |4 oth | |
| 700 | 1 | |a Wright, Neil |e investigator |4 oth | |
| 700 | 1 | |a Yang, Ling |e investigator |4 oth | |
| 700 | 1 | |a Yang, Xiaoming |e investigator |4 oth | |
| 700 | 1 | |a Yao, Pang |e investigator |4 oth | |
| 700 | 1 | |a Guo, Yu |e investigator |4 oth | |
| 700 | 1 | |a Han, Xiao |e investigator |4 oth | |
| 700 | 1 | |a Hou, Can |e investigator |4 oth | |
| 700 | 1 | |a Lv, Jun |e investigator |4 oth | |
| 700 | 1 | |a Pei, Pei |e investigator |4 oth | |
| 700 | 1 | |a Liu, Chao |e investigator |4 oth | |
| 700 | 1 | |a Yu, Canqing |e investigator |4 oth | |
| 700 | 1 | |a Xia, Qingmei |e investigator |4 oth | |
| 700 | 1 | |a Pang, Zengchang |e investigator |4 oth | |
| 700 | 1 | |a Gao, Ruqin |e investigator |4 oth | |
| 700 | 1 | |a Li, Shanpeng |e investigator |4 oth | |
| 700 | 1 | |a Duan, Haiping |e investigator |4 oth | |
| 700 | 1 | |a Wang, Shaojie |e investigator |4 oth | |
| 700 | 1 | |a Liu, Yongmei |e investigator |4 oth | |
| 700 | 1 | |a Du, Ranran |e investigator |4 oth | |
| 700 | 1 | |a Zang, Yajing |e investigator |4 oth | |
| 700 | 1 | |a Cheng, Liang |e investigator |4 oth | |
| 700 | 1 | |a Tian, Xiaocao |e investigator |4 oth | |
| 700 | 1 | |a Zhang, Hua |e investigator |4 oth | |
| 700 | 1 | |a Zhai, Yaoming |e investigator |4 oth | |
| 700 | 1 | |a Ning, Feng |e investigator |4 oth | |
| 700 | 1 | |a Sun, Xiaohui |e investigator |4 oth | |
| 700 | 1 | |a Li, Feifei |e investigator |4 oth | |
| 700 | 1 | |a Lv, Silu |e investigator |4 oth | |
| 700 | 1 | |a Wang, Junzheng |e investigator |4 oth | |
| 700 | 1 | |a Hou, Wei |e investigator |4 oth | |
| 700 | 1 | |a Sun, Wei |e investigator |4 oth | |
| 700 | 1 | |a Yan, Shichun |e investigator |4 oth | |
| 700 | 1 | |a Cui, Xiaoming |e investigator |4 oth | |
| 700 | 1 | |a Wang, Chi |e investigator |4 oth | |
| 700 | 1 | |a Wu, Zhenyuan |e investigator |4 oth | |
| 700 | 1 | |a Li, Yanjie |e investigator |4 oth | |
| 700 | 1 | |a Kang, Quan |e investigator |4 oth | |
| 700 | 1 | |a Luo, Huiming |e investigator |4 oth | |
| 700 | 1 | |a Ou, Tingting |e investigator |4 oth | |
| 700 | 1 | |a Zheng, Xiangyang |e investigator |4 oth | |
| 700 | 1 | |a Guo, Zhendong |e investigator |4 oth | |
| 700 | 1 | |a Wu, Shukuan |e investigator |4 oth | |
| 700 | 1 | |a Li, Yilei |e investigator |4 oth | |
| 700 | 1 | |a Li, Huimei |e investigator |4 oth | |
| 700 | 1 | |a Wu, Ming |e investigator |4 oth | |
| 700 | 1 | |a Zhou, Yonglin |e investigator |4 oth | |
| 700 | 1 | |a Zhou, Jinyi |e investigator |4 oth | |
| 700 | 1 | |a Tao, Ran |e investigator |4 oth | |
| 700 | 1 | |a Yang, Jie |e investigator |4 oth | |
| 700 | 1 | |a Su, Jian |e investigator |4 oth | |
| 700 | 1 | |a Liu, Fang |e investigator |4 oth | |
| 700 | 1 | |a Zhang, Jun |e investigator |4 oth | |
| 700 | 1 | |a Hu, Yihe |e investigator |4 oth | |
| 700 | 1 | |a Lu, Yan |e investigator |4 oth | |
| 700 | 1 | |a Ma, Liangcai |e investigator |4 oth | |
| 700 | 1 | |a Tang, Aiyu |e investigator |4 oth | |
| 773 | 0 | 8 | |i Enthalten in |t The Lancet regional health. Western Pacific |d 2020 |g 42(2024) vom: 08. Jan., Seite 100948 |w (DE-627)NLM320728897 |x 2666-6065 |7 nnns |
| 773 | 1 | 8 | |g volume:42 |g year:2024 |g day:08 |g month:01 |g pages:100948 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.lanwpc.2023.100948 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 42 |j 2024 |b 08 |c 01 |h 100948 | ||