{ "abstract": "Background: Extracellular matrix (ECM) dysregulation, manifesting as fibrosis or tissue destruction, is a hallmark of many chronic diseases, leading to organ dysfunction and mortality. However, ECM-related diseases are rarely considered as a unified group, and their burden remains poorly defined. We aimed to quantify the burden of ECM-related diseases by estimating prevalence and mortality. Methods: We conducted a register-based study using Danish health registers. Chronic diseases were classified as ECM-related, either fibrotic or tissue destruction diseases, based on ICD-10 codes by field experts. Prevalence was estimated using the Danish National Patient Register, and mortality using the Danish Register of Causes of Death. Analyses were stratified by sex, and key analyses were replicated using the UK Biobank cohort (Application ID 31823). Findings: Among 1701 ICD-10 level-two disease codes, we identified 194 fibrotic diseases and 137 tissue destruction diseases, totalling 331 ECM-related diseases. 19% (1120068/5945094) of the population had a fibrotic disease, 30% (1772148/5945094) a tissue destruction disease, and 38% (2250048/5945094) an ECM-related disease, with higher prevalence among women. Mortality rates recorded as underlying causes were 381, 159 and 540 per 100,000 individuals for fibrotic, tissue destruction, and combined ECM-related diseases, accounting for 40% (22715/56795), 17% (9513/56795) and 57% (32228/56795) of deaths. Mortality was higher when ECM-related diseases were recorded as contributing causes of death. Mortality was higher among men. Interpretation: ECM-related diseases impose a substantial burden through high prevalence and mortality. Recognition of ECM dysregulation as a disease mechanism may inform therapeutic strategies and public health planning. Funding: Innovation Fund Denmark.", "abstract_shown": true, "affiliations": [ "Nordic Bioscience, Herlev, Denmark.", "Department of Public Health, Section for Health Data Science and AI, University of Copenhagen, Copenhagen, Denmark.", "Department of Pharmacy, LEO Foundation Center for Cutaneous Drug Delivery, University of Copenhagen, Copenhagen, Denmark.", "Division of Rheumatology, University of Michigan, Ann Arbor, MI, USA.", "Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases Institute, Cleveland Clinic, Cleveland, OH, USA.", "Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.", "Program for Global Translational Inflammatory Bowel Disease, Cleveland Clinic, Cleveland, OH, USA.", "Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054, Erlangen, Germany.", "Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.", "National Institute for Health and Care Research Leeds Biomedical Research Centre, Leeds, UK.", "Department of Cancer Biology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.", "Department of Bioengineering, Rice University, Houston, TX, USA.", "Department of Electrical and Computer Engineering, Rice University, Houston, TX, USA.", "Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA.", "Institute for Liver Research, Icahn School of Medicine at Mount Sinai, New York, USA.", "Department of Cardiology, Cardiovascular Research Institute Maastricht, University of Maastricht & Maastricht University Medical Centre, Maastricht, Netherlands.", "Department of Cardiovascular Sciences, Centre for Vascular and Molecular Biology, KU Leuven, Leuven, Belgium.", "Hastings Centre for Pulmonary Research and Division of Pulmonary, Critical Care and Sleep Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.", "National Heart and Lung Institute, Imperial College London, London, UK." ], "article_type": "research article", "arxiv": null, "author_total": 21, "authors": [ { "affs": [ 0, 1 ], "name": "Rosa C Christiansen" }, { "affs": [ 0 ], "name": "Cecilie L Bager" }, { "affs": [ 2 ], "name": "Andrea Heinz", "orcid": "0000-0002-8609-4460" }, { "affs": [ 0 ], "name": "Anne C Bay-Jensen" }, { "affs": [ 0 ], "name": "Diana J Leeming" }, { "affs": [ 3 ], "name": "Dinesh Khanna" }, { "affs": [ 0 ], "name": "Federica Genovese" }, { "affs": [ 4, 5, 6 ], "name": "Florian Rieder" }, { "affs": [ 7 ], "name": "Georg Schett" }, { "affs": [ 0 ], "name": "Joachim H Mortensen" }, { "affs": [ 0 ], "name": "Kim Henriksen" }, { "affs": [ 0 ], "name": "Nicholas Willumsen" }, { "affs": [ 8, 9 ], "name": "Philip G Conaghan" }, { "affs": [ 10, 11, 12, 13 ], "name": "Raghu Kalluri" }, { "affs": [ 14 ], "name": "Scott L Friedman" }, { "affs": [ 0 ], "name": "Signe Holm Nielsen" }, { "affs": [ 0 ], "name": "Signe Larsen" }, { "affs": [ 15, 16 ], "name": "Stephane Heymans" }, { "affs": [ 17, 18 ], "name": "Toby M Maher" }, { "affs": [ 1 ], "name": "Søren Brunak" }, { "affs": [ 0 ], "name": "Morten A Karsdal" } ], "bibtex": "https://research.draconitic.com/paper/cdrgyf60jntbq.bib", "cited_by": 0, "doi": "10.1016/j.lanepe.2026.101901", "fulltext_url": "http://www.sciencedirect.com/science/article/pii/S2666776226003133", "id": "cdrgyf60jntbq", "issns": [ "2666-7762" ], "landing_url": "https://doi.org/10.1016/j.lanepe.2026.101901", "language": "en", "licence": "CC-BY-NC", "licence_label": "CC BY-NC", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Articles" ], [ "lcc", "RA1-1270" ], [ "openalex", "2713|Chronic Disease Management Strategies" ] ], "openalex": "W7223348996", "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13718482/pdf/?tool=EBI", "pmcid": "PMC13718482", "pmid": "42960173", "published": "2026-10-23", "publisher": "Elsevier", "ris": "https://research.draconitic.com/paper/cdrgyf60jntbq.ris", "sources": [ { "first_seen": "2026-10-30T13:44:30Z", "native_id": "502de56f384f4bdeb0ba9fddde4f8cb4", "source": "doaj", "url": "https://doi.org/10.1016/j.lanepe.2026.101901" }, { "first_seen": "2026-10-31T00:20:37Z", "native_id": "PMC:PMC13718482", "source": "europepmc", "url": "https://europepmc.org/article/PMC/PMC13718482" }, { "first_seen": "2026-11-01T00:20:50Z", "native_id": "MED:42960173", "source": "europepmc", "url": "https://europepmc.org/article/MED/42960173" }, { "first_seen": "2026-11-02T12:22:30Z", "native_id": "PMC13718482", "source": "pmc", "url": "https://doi.org/10.1016/j.lanepe.2026.101901" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2713|Chronic Disease Management Strategies", "subfield": "epidemiology-public-health" } ], "title": "Prevalence and mortality of chronic extracellular matrix dysregulated diseases: a nationwide register-based study", "title_text": "Prevalence and mortality of chronic extracellular matrix dysregulated diseases: a nationwide register-based study", "type": "peer-reviewed", "updated_at": "2026-11-02T12:22:30Z", "url": "https://research.draconitic.com/paper/cdrgyf60jntbq", "venue": "The Lancet Regional Health. Europe", "versions": [] }