A Retrospective Real-World Cohort Study

• No treatment given (Other): No treatment given

Primary outcomes

• Index and yearly prevalence of major cardiometabolic diseases (percentage) [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025), and at the end of each calendar year]: Measured in percentage
• Index and yearly prevalence of major cardiometabolic diseases: binary (yes/no) [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025), and at the end of each calendar year]: Measured as binary (yes/no)
• Overlap of major cardiometabolic diseases (percentage) [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Presence of two or more predefined cardiometabolic conditions documented on or prior to the index date. Measured as percentage
• Overlap of major cardiometabolic diseases: binary (yes/no) [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Presence of two or more predefined cardiometabolic conditions documented on or prior to the index date. Measured as binary (yes/no)
• Age distribution [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in years
• Age distribution: Number of participants [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured as number of participants
• Gender distribution [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Defined as male or female. Measured in percentage
• Gender distribution: binary (yes/no) [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Defined as count of male or female. Measured as binary (male/female)
• BMI distribution [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured as kilogram (kg)/m\^2
• BMI distribution: number of participants [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured categorically: number of participants (under 18, 18-25, 25-30, and above 30 kg/m\^2 )
• Medical history of interest: percentage of events [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in percentage of events
• Smoking status: percentage of participants [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Defined by the next categories at index date non-smoker, formal smoker, occasional smoker or current smoker. Measured in percentage of participants
• Systolic and diastolic blood pressure (BP) [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in millimeters of mercury (mmHg)
• Laboratory assessment of C reactive protein (CRP)/high sensitive (hs)-CRP [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in milligram (mg) /Liter (L)
• Laboratory assessment of CRP/hs-CRP: binary (under and above 2 mg/L) [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Laboratory assessment of CRP . Measured as binary (under and above 2 mg/L)
• Laboratory assessment of ferritin [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in nanogram (ng)/mL
• Laboratory assessment of transferrin [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in mg/ deciliter (dL)
• Laboratory assessment of serum creatinine [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in mg/dL
• Laboratory assessment of estimated glomerular filtration rate (eGFR) [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in mL/min/1.73m\^2 in categories (under 30 / 30-44 / 45-59 / above or equal to 60 mL/min/1.73m\^2)
• Laboratory assessment of creatinine clearance (CrCl) [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in mL/ minute (min)
• Laboratory assessment of serum albumin levels [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in grams (g)/dL
• Laboratory assessment of albuminuria [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Defined as UACR (urine albumin-to-creatinine ratio) under 30 (A1), above or equal to 30 (A2), or above or equal to 300 mg/g (A3). Measured in mg/g in categories (A1 / A2 / A3)
• Laboratory assessment of albumin-to-creatinine ratio (ACR) [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in mg/g
• Laboratory assessment of platelets [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in 10\^9 cells/L
• Laboratory assessment of neutrophils [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in 10\^9 cells/L
• Laboratory assessment of lymphocytes [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in 10\^9 cells/L
• Laboratory assessment of monocytes [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in 10\^9 cells/L
• Laboratory assessment of troponin T (TnT)/high sensitive (hs)-TnT [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in ng/L
• Laboratory assessment of troponin I (TnI)/high sensitive (hs)-TnI [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in ng/L
• Laboratory assessment of fasting glucose [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in mg/dL
• Laboratory assessment of hemoglobin (Hb) [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in g/dL
• Laboratory assessment of hemoglobin A1c (HbA1c) [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in percentage of total Hb
• Laboratory assessment of triglycerides [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in mg/dL
• Laboratory assessment of total cholesterol [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in mg/dL
• Laboratory assessment of low-density lipoprotein cholesterol (LDL-c) [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in mg/dL
• Laboratory assessment of high-density lipoprotein cholesterol (HDL-c) [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in mg/dL
• Laboratory assessment of lipoprotein A (LpA) [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in mg/dL
• Laboratory assessment of alanine transaminase (ALT) [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in unit (U) /L
• Laboratory assessment of aspartate transaminase (AST) [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in U/L
• Laboratory assessment of FIB-4 score [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: FIB-4 liver fibrosis score, with previously validated cut-off points to rule in and out the risk of advanced liver fibrosis. FIB-4 score indicating low to high risk ranges from 0.1 (low risk) to 20 (highest risk), where the higher score indicates a higher risk or greater severity of advanced liver fibrosis. Measured categorically as score on the scale (under 1.45, 1.45-2.67, and above 2.67).
• Laboratory assessment of N-terminal pro-Btype natriuretic peptide (NTproBNP) levels [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in ng/L
• Laboratory assessment of thyroid-stimulating hormone (TSH) levels [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in milli-unit (mU)/L
• Laboratory assessment of follicle-stimulating hormone (FSH) levels [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in U/L
• Laboratory assessment of luteinizing hormone (LH) levels [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in U/L
• Laboratory assessment of progesterone levels [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in ng/mL
• Laboratory assessment of estrogen levels [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in picograms (pg)/mL
• Laboratory assessment of testosterone levels [Baseline (at index date i.e., between 1 January 2022 to 31 December 2025)]: Measured in ng/dL

Sex: All, ages: 12 Years to any

Inclusion Criteria:

* Participants aged above or equal to 12 years at index date.
* Participants with international classification of diseases (ICD-10) coded diagnosis or secondary criteria for either diabetes (type 2 diabetes, pre-diabetes), overweight, obesity, metabolic dysfunction-associated steatotic liver disease (or non-alcoholic fatty liver disease), cardiovascular disease (arterial hypertension, ischemic heart disease, myocardial infarction, heart failure, cerebrovascular disease (including stroke and transient ischemic attack), atherosclerosis, atrial fibrillation), chronic kidney disease, dyslipidemia.
* At least one healthcare encounter within 12 months prior to index date (pre-index) to ensure availability of baseline data.

Exclusion Criteria:

* None.

• Clinical Transparency (dept. 2834), Study director, Novo Nordisk A/S