EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Pl +2, Paseo Isabel la Católica 1-3, 50009, Zaragoza, Spain; Department of Microbiology, Preventive Medicine and Public Health, University of Zaragoza, Facultad de Medicina, C/ Domingo Miral s/n, 50009, Zaragoza, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, Madrid, Spain; Teaching Unit of Preventive Medicine and Public Health, Aragón Health Sciences Institute (IACS), IIS Aragón, Edificio CIBA, Avda. San Juan Bosco 13, 50009, Zaragoza, Spain.
EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Pl +2, Paseo Isabel la Católica 1-3, 50009, Zaragoza, Spain; Department of Microbiology, Preventive Medicine and Public Health, University of Zaragoza, Facultad de Medicina, C/ Domingo Miral s/n, 50009, Zaragoza, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, Madrid, Spain; Teaching Unit of Preventive Medicine and Public Health, Aragón Health Sciences Institute (IACS), IIS Aragón, Edificio CIBA, Avda. San Juan Bosco 13, 50009, Zaragoza, Spain.
J Clin Epidemiol. 2014 Mar;67(3):254-66. doi: 10.1016/j.jclinepi.2013.09.021.
The aim of this review was to identify studies on patterns of associative multimorbidity, defined as the nonrandom association between diseases, focusing on the main methodological features of the studies and the similarities among the detected patterns.
Studies were identified through MEDLINE and EMBASE electronic database searches from their inception to June 2012 and bibliographies.
The final 14 articles exhibited methodological heterogeneity in terms of the sample size, age and recruitment of study participants, the data source, the number of baseline diseases considered, and the statistical procedure used. A total of 97 patterns composed of two or more diseases were identified. Among these, 63 patterns were composed of three or more diseases. Despite the methodological variability among studies, this review demonstrated relevant similarities for three groups of patterns. The first one comprised a combination of cardiovascular and metabolic diseases, the second one was related with mental health problems, and the third one with musculoskeletal disorders.
The existence of associations beyond chance among the different diseases that comprise these patterns should be considered with the aim of directing future lines of research that measure their intensity, clarify their nature, and highlight the possible causal underlying mechanisms.
本综述旨在识别关联型多重疾病模式的研究，关联型多重疾病是指疾病之间并非随机关联，重点关注研究的主要方法特征和所发现模式之间的相似性。
通过 MEDLINE 和 EMBASE 电子数据库从建库到 2012 年 6 月的检索以及参考文献的追溯进行研究筛选。
最终纳入的 14 篇文章在样本量、研究参与者的年龄和招募、数据来源、考虑的基础疾病数量以及所使用的统计程序方面存在方法学异质性。共确定了 97 种由两种或两种以上疾病组成的模式。其中，有 63 种模式由三种或三种以上疾病组成。尽管研究之间存在方法学的可变性，但本综述为三组模式显示了相关的相似性。第一组包括心血管和代谢疾病的组合，第二组与心理健康问题有关，第三组与肌肉骨骼疾病有关。
这些模式中不同疾病之间存在关联而非偶然，这一事实应加以考虑，目的是指导未来的研究路线，测量其关联强度，阐明其性质，并强调潜在的因果关系机制。
