MorbiNet: multimorbidity networks in adult general population. Analysis of type 2 diabetes mellitus comorbidity

Abstract

Multimorbidity has great impact on health care. We constructed multimorbidity networks in the general population, extracted subnets focused on common chronic conditions and analysed type 2 diabetes mellitus (T2DM) comorbidity network. We used electronic records from 3,135,948 adult people in Catalonia, Spain (539,909 with T2DM), with at least 2 coexistent chronic conditions within the study period (2006-2017). We constructed networks from odds-ratio estimates adjusted by age and sex and considered connections with oR > 1.2 and p-value < 1e-5. Directed networks and trajectories were derived from temporal associations. interactive networks are freely available in a website with the option to customize characteristics and subnets. The more connected conditions in T2DM undirected network were: complicated hypertension and atherosclerosis/peripheral vascular disease (degree: 32), cholecystitis/cholelithiasis, retinopathy and peripheral neuritis/neuropathy (degree: 31). T2DM has moderate number of connections and centrality but is associated with conditions with high scores in the multimorbidity network (neuropathy, anaemia and digestive diseases), and severe conditions with poor prognosis. The strongest associations from T2DM directed networks were to retinopathy (OR: 23.8), glomerulonephritis/nephrosis (OR: 3.4), peripheral neuritis/neuropathy (OR: 2.7) and pancreas cancer (OR: 2.4). Temporal associations showed the relevance of retinopathy in the progression to complicated hypertension, cerebrovascular disease, ischemic heart disease and organ failure.

Examining multimorbidity differences across racial groups: a network analysis of electronic medical records

“…In addition, to find all types of multimorbidities across population groups hidden in a large EMR, an advanced data analytics method, network analysis, is applied. We use network analysis to model all comorbidities together through a network of diagnoses 10 . Additionally, our analytical model allows a specific focus on organ system level multimorbidities, in order to create networks at organ system level to explore the relationship between diagnoses belonging to different organ systems.…”

Characterizing Multimorbidity from Type 2 Diabetes

“…Concordant comorbidities, such as hypertension and cardiovascular and microvascular conditions, dominated clusters across the studies, agreeing with global trends in T2DM complications 27 and novel nonclustering studies. 41 Hypertension was the most central condition, indicating it was an important mediator of connections between other conditions, seen across various subgroups. 41 This finding is consistent with the long-standing literature that hypertension is the key driver in the development of cardiovascular and microvascular conditions.…”

Comorbidity network analysis related to obesity in middle-aged and older adults: findings from Korean population-based survey data

“…Although obesity has been accepted as a predisposing factor for the development of various chronic diseases such as CVD and metabolic diseases, the definition of obesity-related diseases has unclear boundaries. Comorbidity network analysis provides insights to help understand obesity-related diseases and can provide information for patient care and treatment in a medical setting [ 9 , 10 , 16 ]. By obtaining data on the prevalence of chronic diseases with a long disease duration, a snapshot was taken of the distribution of comorbid diseases, and our results are in line with those of previous studies.…”