Longitudinal multimorbidity trajectories shape personalized glycaemic patterns
Ke Zhang1,2,3, Jieteng Chen1,2,3, Yan Yan4
1Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, China.
Nature Metabolism
|April 16, 2026
Summary
Cumulative chronic diseases in older adults significantly impact blood sugar control and dietary responses. This study introduces a multimorbidity index to guide personalized glycaemic management and dietary interventions.
Area of Science:
- Gerontology
- Metabolic Health
- Chronic Disease Epidemiology
Background:
- Older adults frequently experience multiple chronic diseases (multimorbidity), but its impact on blood sugar regulation is not fully understood.
- Glycaemic variability and individual responses to diet are critical aspects of metabolic health in aging populations.
Purpose of the Study:
- To investigate the relationship between cumulative disease burden and glycaemic dysregulation in older adults.
- To develop and validate a systemic multimorbidity index (MMI-system) for assessing chronic disease impact.
- To explore the role of proteomic profiles in mediating the effects of multimorbidity on glycaemic responses to dietary challenges.
Main Methods:
- Longitudinal tracking of 1,398 participants over 12 years in the Guangzhou Nutrition and Health Study.
- Development of a systemic multimorbidity index (MMI-system) to quantify cumulative chronic disease burden.
- Continuous glucose monitoring and proteomic analysis (lipid homeostasis proteins) to assess glycaemic dynamics and dietary responses.
- Independent validation in the China Health and Nutrition Survey cohort.
Main Results:
- The MMI-system showed a dose-dependent association with increased glycaemic variability and altered sensitivity to dietary challenges, irrespective of diabetes status.
- Lipid homeostasis proteins accounted for 12.9% of the association between MMI-system and personalized dietary responses.
- Findings were consistently validated in an independent cohort, confirming the robustness of the multimorbidity index.
Conclusions:
- Cumulative disease trajectories, as measured by the MMI-system, significantly influence glycaemic variability and dietary responses in aging individuals.
- Integrating multimorbidity profiling with proteomic data offers a promising approach for precision glycaemic management in older adults.
- These insights can inform the development of targeted dietary interventions to improve metabolic health in the elderly.
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