AUTHOR=Xu Qiaoyi , Liu Zhenqiu , Zhao Renjia , Cui Zixuan , Xing Xufei , Chen Xingdong , Suo Chen 
  
TITLE=Multimodal risk profiles reveal shared and disease-specific risks of major non-communicable diseases: a prospective cohort study of 42,666 individuals 
  
JOURNAL=International Journal of Public Health
  
VOLUME=Volume 71 - 2026
  
YEAR=2026
  
URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2026.1609591
  
DOI=10.3389/ijph.2026.1609591
  
ISSN=1661-8564
  
ABSTRACT=ObjectivesEvaluate whether circulating blood biomarker profiles identify shared and disease-specific risks of non-communicable diseases (NCDs).MethodsWe considered 42,666 participants from Taizhou, China. After exclusions, discovery (n = 14,478; recruited 2011.9–2014.1) and temporal validation (n = 25,018; recruited 2018.7–2021.11) cohorts were defined. We integrated 54 blood biomarkers and 26 questionnaire/physical indicators. Predictors were selected after Cox pre-screening based on concordant inclusion across stepwise regression, regularized regression, and Boruta random forest.ResultsThe final score included 15 biomarkers plus age, smoking, hypertension, and vegetable intake. In the temporal validation cohort, high-risk individuals (25.0% of participants) accounted for 53.9% of incident major NCD cases, with a 6.29-fold (4.83–8.19) higher risk than the low-risk group. Similar gradients were observed for all-cause mortality. Compared with disease-specific scores, the combined score effectively stratified both composite and individual outcomes and revealed shared risks: 56.1% of disease-specific high-risk individuals were also high risk for other NCDs.ConclusionA score integrating blood biomarkers with epidemiological and physical measures achieved clear risk stratification in the temporal validation cohort and may support priority population identification for major NCDs.