{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T01:42:08Z","timestamp":1772329328428,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,6,8]],"date-time":"2024-06-08T00:00:00Z","timestamp":1717804800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Comorbidities in primary care do not occur in isolation but tend to cluster together causing various clinically complex phenotypes. This study aimed to distinguish phenotype clusters and identify the risks of all\u2010cause mortality in primary care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The baseline cohort of the LIPIDOGEN2015 sub\u2010study involved 1779 patients recruited by 438 primary care physicians. To identify different phenotype clusters, we used hierarchical clustering and investigated differences between clinical characteristics and mortality between clusters. We then performed causal analyses using causal mediation analysis to explore potential mediators between different clusters and all\u2010cause mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1756 patients were included (mean age 51.2, SD 13.0; 60.3% female), with a median follow\u2010up of 5.7\u2009years. Three clusters were identified: Cluster 1 (<jats:italic>n<\/jats:italic>\u2009=\u2009543) was characterised by overweight\/obesity (body mass index\u2009\u2265\u200925\u2009kg\/m<jats:sup>2<\/jats:sup>), older (age\u2009\u2265\u200965\u2009years), more comorbidities; Cluster 2 (<jats:italic>n<\/jats:italic>\u2009=\u2009459) was characterised by non\u2010overweight\/obesity, younger, fewer comorbidities; Cluster 3 (<jats:italic>n<\/jats:italic>\u2009=\u2009754) was characterised by overweight\/obesity, younger, fewer comorbidities. Adjusted Cox regression showed that compared with Cluster 2, Cluster 1 had a significantly higher risk of all\u2010cause mortality (HR 3.87, 95% CI: 1.24\u201315.91), whereas this was insignificantly different for Cluster 3. Causal mediation analyses showed that decreased protein thiol groups mediated the hazard effect of all\u2010cause mortality in Cluster 1 compared with Cluster 2, but not between Clusters 1 and 3.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Overweight\/obesity older patients with more comorbidities had the highest risk of long\u2010term all\u2010cause mortality, and in the young group population overweight\/obesity insignificantly increased the risk in the long\u2010term follow\u2010up, providing a basis for stratified phenotypic risk management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.14261","type":"journal-article","created":{"date-parts":[[2024,6,8]],"date-time":"2024-06-08T08:40:00Z","timestamp":1717836000000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Phenotypes of Polish primary care patients using hierarchical clustering: Exploring the risk of mortality in the <scp>LIPIDOGEN2015<\/scp> study cohort"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2808-6286","authenticated-orcid":false,"given":"Yang","family":"Chen","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University, Liverpool Heart and Chest Hospital  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9994-8915","authenticated-orcid":false,"given":"Ying","family":"Gue","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University, Liverpool Heart and Chest Hospital  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maciej","family":"Banach","sequence":"additional","affiliation":[{"name":"Ciccarone Center for the Prevention of Cardiovascular Disease Johns Hopkins University School of Medicine  Baltimore Maryland USA"},{"name":"Department of Preventive Cardiology and Lipidology Medical University of Lodz  Lodz Poland"},{"name":"Department of Cardiology and Adult Congenital Heart Diseases Polish Mother's Memorial Hospital Research Institute (PMMHRI)  Lodz Poland"},{"name":"Cardiovascular Research Centre University of Zielona Gora  Zielona Gora Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitri","family":"Mikhailidis","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, Royal Free Hospital Campus University College London Medical School, University College London (UCL)  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter P.","family":"Toth","sequence":"additional","affiliation":[{"name":"Ciccarone Center for the Prevention of Cardiovascular Disease Johns Hopkins University School of Medicine  Baltimore Maryland USA"},{"name":"Department of Preventive Cardiology CGH Medical Center  Sterling Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marek","family":"Gierlotka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Institute of Medical Sciences University of Opole  Opole Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadeusz","family":"Osadnik","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences in Zabrze, Department of Pharmacology Medical University of Silesia  Zabrze Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcin","family":"Golawski","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences in Zabrze, Department of Pharmacology Medical University of Silesia  Zabrze Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasz","family":"Tomasik","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Jagiellonian University Medical College  Krak\u00f3w Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Windak","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Jagiellonian University Medical College  Krak\u00f3w Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacek","family":"Jozwiak","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Public Health, Institute of Medical Sciences University of Opole  Opole Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University, Liverpool Heart and Chest Hospital  Liverpool UK"},{"name":"Danish Centre for Health Services Research, Department of Clinical Medicine Aalborg University  Aalborg Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the LIPIDOGRAM Investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,6,8]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32335-3"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0226766"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1314"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-12-286"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2019.109785"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-019-1373-y"},{"issue":"3","key":"e_1_2_11_8_1","first-page":"604","article-title":"Design and rationale of a nationwide screening analysis from the LIPIDOGRAM2015 and LIPIDOGEN2015 studies","volume":"18","author":"J\u00f3\u017awiak JJ","year":"2022","journal-title":"Arch Med Sci"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10235656"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-021-02120-3"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyab085"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0141155"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-018986"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP271691"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494818764810"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30949-7"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30175-1"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2012.29"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-023-02059-0"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2021.101268"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI120842"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cotox.2018.03.005"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/antiox11061065"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S356029"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2009.05.007"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.freeradbiomed.2022.05.020"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-83962-y"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2019.04.180341"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-020-01587-w"}],"container-title":["European Journal of Clinical Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eci.14261","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T13:48:02Z","timestamp":1729691282000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/eci.14261"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,8]]},"references-count":28,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1111\/eci.14261"],"URL":"https:\/\/doi.org\/10.1111\/eci.14261","archive":["Portico"],"relation":{},"ISSN":["0014-2972","1365-2362"],"issn-type":[{"value":"0014-2972","type":"print"},{"value":"1365-2362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,8]]},"assertion":[{"value":"2024-04-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14261"}}