Background Multimorbidity is common among the middle-aged and elderly residents. And it is associated to the reduction of health-related quality of life (HRQoL), including physical and psychological dimensions. However, there are few studies that have paid attention to the HRQoL of residents with multimorbidity in China. Therefore, this study aims to investigate the relationships between different multimorbidity patterns and HRQoL among middle-aged and elderly adults in China. Methods Based on a cross-sectional survey, the information regarding 18,137 adults, who were at least 45 years of age, was collected through interviews. Self-perceived HRQoL was assessed with the EQ-5D-3 L instrument, and the EQ-5D-3 L index score was calculated using the Chinese EQ-5D-3 L value set. The Tobit regression was used to explore the impacts of multimorbidity groups on HRQoL. Results Of 18,137 respondents, more than a fifth (3773,20.8%) of people had multimorbidity. Mean (SD) of EQ-5D index and VAS values were 0.95(0.14) and 76.02(13.66), respectively. Significant correlations were found between a lower HRQoL and increasing numbers of chronic conditions ( P < 0.001). Most of chronic diseases co-occurred frequently, and the association between hypertension and diabetes mellitus was the strongest (adjusted OR = 3.82). The most prevalent disease is hypertension (5052,27.9%), and the most prevalent chronic diseases pair is hypertension and diabetes mellitus (841,4.6%). Among those chronic diseases with high prevalence, the effects on HRQoL ranged from chronic pain to hypertension (adjust b = − 0.036 to − 0.008). In the common multimorbidity patterns, co-occurrence of chronic pain and bone disease (adjust b = − 0.039) had the greatest impact on HRQoL. Conclusions The HRQoL of middle-aged and elderly adults declines by multimorbidity. More attention should be paid to the HRQoL of residents with multimorbidity in China. The effect of different multimorbidity patterns on HRQoL is not simply added by two diseases, but changes by the different combination. Identifying different multimorbidity patterns of residents can provide more targeted measures to improve the HRQoL.

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ObjectivesThis study aimed at investigating the applicability of a novel index based on waist circumference (WC) and triglyceride (TG) which was named lipid accumulation product (LAP) in the Southern Chinese population, and compared the predictive effects of LAP and other obesity indicators on hypertension risk. Moreover, this study investigated the interactive effects of LAP and family history of hypertension.MethodsA total number of 2079 of community-dwelling adults in Southern China were enrolled in this cross-sectional study. The participants underwent questionnaire surveys, anthropometric tests and laboratory examinations. Themultinomial logistic regression model and receiver operating characteristic curves, including LAP, body mass index (BMI), waist-to-hip ratio (WHR), WC and TG, were used to assess the association between hypertension risk and obesity indexes. The interaction effects were evaluated by relative excess risk of interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI).ResultsHigher LAP levels have a relatively higher risk of having hypertension in both sexes (males: adjusted OR=2.79 per SD increase, 95% CI 1.43 to 5.44, p<0.001; females: adjusted OR=3.15, 95% CI 1.56 to 6.39, p<0.001). LAP (area under the curve=0.721; 95% CI 0.680 to 0.761) is a better indicator in identifying hypertension risk than BMI, WHR and TG in females, but WC performed better in males. A significant interaction between LAP and family history of hypertension was observed in males (RERI=1.652, 95% CI 0.267 to 3.037; AP=0.516, 95% CI 0.238 to 0.794; SI=3.998, 95% CI 0.897 to 17.820), but there is no statistically significant difference in females.ConclusionsLAP significantly associates with hypertension risk in the Southern Chinese population. It has better performance than BMI, WHR and TG on predicting hypertension risk of the Southern Chinese female population. Moreover, LAP and family history of hypertension might synergistically increase the risk of hypertension.

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