Multimorbidity clusters, trajectories and genetic risk, in British south Asians
Description: Our research proposal covers an important area of health called 'multimorbidity', which describes where an individual is affected by 2 or more health conditions. Studies have shown that multimorbidity is getting more common in the United Kingdom, and the National Health Service does (NHS) not currently have services designed to tackle it well. Recent research has also shown that multimorbidity exists in 'clusters', with groups of common conditions (e.g. type 2 diabetes, high blood pressure, chronic pain, and depression) often co-exist. However, there is a lot still to learn about multimorbidity, and more research is needed to find out why it occurs, who is at risk, and how to design better health and social care to manage it. Our proposal will produce new knowledge that fills some of the important gaps in our understanding of multimorbidity.
We will study multimorbidity in people living in a large east London population of 1.05million people, one-third of whom come from a south Asian ethnic group and who live in high socioeconomic deprivation; both known to be risk factors for multimorbidity. Data collected in electronic health records (e.g. the diagnoses made or treatments given to you when you visit your GP) will be used to inform us about multimorbidity in this population. We will use state-of-the-art statistical techniques that use this data to tell us which are the most common 'clusters' of multimorbidity in east London, and whether they vary in British south Asians compared to Whites. Using historical records, we will study patterns of multimorbidity clusters during a person's life, what risk factors might be associated with them, and how severely they may impact an individual.
The next focus in our research will be to investigate the genetic causes of multimorbidity using cutting edge studies of the genome in volunteers participating in the East London Genes and Health (ELGH) study. ELGH is a large study of people of British-Bangladeshi and -Pakistani origin living in east London, with 32,000 volunteers involved already. Volunteers in ELGH have given consent for us to access their electronic health records and also study their genes using a spit sample donated to the study. We will investigate whether differences in the genetic code of individuals are linked to the risk of multimorbidity. One specific genetic code change we will be looking at is called 'autozygosity', a phenomenon affecting some people in these ethnic groups where parental relatedness is common. Autozygosity increases the chance that gene copies inherited from a person's mother and father are the same, and some studies have shown that this is linked to certain disease. We will study whether the amount of autozygosity in a person's genetic make-up could affect a person's risk of developing multimorbidity. We will also investigate an area of major interest in genetic and health studies at the moment, called polygenic risk scores (PRS). These scores identify multiple, small changes to an individual's genetic code that, when added together using a mathematical formula, strongly predict whether someone is at risk of developing conditions such as heart disease. PRSs have been studied mostly in people of White ethnic groups, and we will contribute to wider efforts to investigate their impact on disease and multimorbidity in south Asians.
Our research will use potentially sensitive data for our studies and we will take very stringent and careful approaches to using this data so that there are no data security issues, and to ensure all data has been collected using appropriate consent and information governance procedures.
We expect that the impact of our research will be wide-ranging, including supporting improvements in health and social care for multimorbidity and perhaps more efficient use of limited NHS funds. We will deliver direct benefits back to our research volunteers through educational programmes and public engagement.
Funder: Medical Research Council
Amount: £505,600
Funding type: research
Start date: 2020-03-01
End date: 2023-05-30
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Funded outputs count: 7
Funder award ID: MR/S027297/1
OpenAlex ID: G7463202808