Non-Communicable Disease Risk Factors and Their Clustering Among Adults in Urban Bangladesh: A Cross-Sectional Study

Background: Non-communicable disease (NCD) risk factors frequently co-occur, but quantitative evidence on their clustering among urban Bangladeshi adults is limited. Objective: To estimate the prevalence of seven NCD risk factors and their clustering among adults aged 18–65 years in urban Bangladesh, and to identify factors associated with clustering. Methods: This cross-sectional study included 362 adults aged 18–65 years between January and December 2025. Behavioural, anthropometric, blood pressure, fasting glucose and total cholesterol data were analysed. Clustering (three or more of seven factors) was compared with the distribution expected under independence and modelled using multivariable logistic regression adjusted for age, sex, education, income, marital status and family history. Results: Mean age was 40.9 ± 10.9 years; 51.4% were male. Insufficient fruit and vegetable intake (78.5%), physical inactivity (49.2%) and BMI ≥25 kg/m² (45.6%) predominated; raised blood pressure or treatment affected 38.4%. In total, 196 participants (54.1%; 95% CI 49.0–59.2) had three or more and 86 (23.8%) had four or more risk factors. The number with four or more matched expectation under independence (86 vs 86.4), although the variance of the count exceeded it (1.62 vs 1.34; P = 0.002). Odds of three or more factors rose with age (50–65 vs 18–29 years: adjusted OR 5.43; 95% CI 2.52–11.66). Sex, education and family history were not associated. Conclusion: Multiple risk factors were common among urban adults and accumulated steeply with age from early adulthood, supporting integrated multi-risk screening. Causal inference is precluded by the cross-sectional design.