Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, China.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Beijing, 100191, China.
BMC Public Health. 2018 Jun 15;18(1):744. doi: 10.1186/s12889-018-5632-1.
Understanding the correlates of self-rated health (SRH) can help public health professionals prioritize health-promotion and disease-prevention interventions. This study aimed to investigate the association between multiple comorbidities and global SRH and age-comparative SRH.
A total of 512,891 participants aged 30-79 years old were recruited into the China Kadoorie Biobank study from ten regions between 2004 and 2008. Multivariate logistic regression models were used to estimate the odds ratios (ORs) for the associations between comorbidities (including diabetes, hypertension, coronary heart disease, rheumatic heart disease, stroke, tuberculosis, emphysema/bronchitis, asthma, cirrhosis/chronic hepatitis, peptic ulcer, gallbladder disease, kidney disease, fracture, rheumatic arthritis, psychiatric disorders, depressive symptoms, neurasthenia, head injury and cancer) and SRH. Population attributable risks (PARs) were used to estimate the contribution of multiple comorbidities to poor global SRH and worse age-comparative SRH.
After adjusting for covariates, suffering from various diseases increased the chance of reporting a poor global SRH [OR (95% CI) ranged from 1.10 (1.07, 1.13) for fracture to 3.21 (2.68, 3.83) for rheumatic heart disease] and a worse age-comparative SRH [OR (95% CI) ranged from 1.18 (1.13, 1.23) for fracture to 7.56 (6.93, 8.25) for stroke]. From the population perspective, 20.23% of poor global SRH and 45.12% of worse age-comparative SRH could attributed to the cardiometabolic diseases, with hypertension (7.84% for poor global SRH and 13.79% for worse age-comparative SRH), diabetes (4.35% for poor global SRH and 10.71% for worse age-comparative SRH), coronary heart disease (4.44% for poor global SRH and 9.51% for worse age-comparative SRH) and stroke (3.20% for poor global SRH and 10.19% for worse age-comparative SRH) making the largest contribution.
Various diseases were major determinants of global and age-comparative SRH, and cardiometabolic diseases had the strongest impact on both global SRH and age-comparative SRH at the population level. Prevention measures concentrated on these conditions would greatly reduce the total burden of poor SRH and its consequences such as poor quality of life and use of health care services.
了解自评健康（SRH）的相关因素可以帮助公共卫生专业人员优先考虑促进健康和预防疾病的干预措施。本研究旨在探讨多种合并症与全球 SRH 和年龄比较性 SRH 之间的关联。
2004 年至 2008 年期间，从中国十个地区招募了 512891 名年龄在 30-79 岁之间的参与者参加中国科克伦生物库研究。使用多变量逻辑回归模型估计合并症（包括糖尿病、高血压、冠心病、风湿性心脏病、中风、结核病、肺气肿/支气管炎、哮喘、肝硬化/慢性肝炎、胃溃疡、胆囊疾病、肾脏疾病、骨折、风湿性关节炎、精神障碍、抑郁症状、神经衰弱、头部损伤和癌症）与 SRH 之间关联的比值比（OR）。人群归因风险（PAR）用于估计多种合并症对全球 SRH 不良和年龄比较性 SRH 较差的贡献。
调整了协变量后，患有各种疾病会增加报告全球 SRH 不良的机会[比值比（95%置信区间）范围为骨折的 1.10（1.07，1.13）至风湿性心脏病的 3.21（2.68，3.83）]和年龄比较性 SRH 较差的机会[比值比（95%置信区间）范围为骨折的 1.18（1.13，1.23）至中风的 7.56（6.93，8.25）]。从人群角度来看，20.23%的全球 SRH 不良和 45.12%的年龄比较性 SRH 较差可归因于心血管疾病，其中高血压（全球 SRH 不良的 7.84%和年龄比较性 SRH 较差的 13.79%）、糖尿病（全球 SRH 不良的 4.35%和年龄比较性 SRH 较差的 10.71%）、冠心病（全球 SRH 不良的 4.44%和年龄比较性 SRH 较差的 9.51%）和中风（全球 SRH 不良的 3.20%和年龄比较性 SRH 较差的 10.19%）的贡献最大。
各种疾病是全球和年龄比较性 SRH 的主要决定因素，在人群水平上，心血管代谢疾病对全球 SRH 和年龄比较性 SRH 都有最强的影响。集中预防这些疾病将大大降低不良 SRH 的总负担及其后果，如生活质量下降和卫生保健服务的使用。
