Hui Liu
Department of Clinical Immunology, Dalian Medical University, Dalian, 116044, People's Republic of China.
BMC Gastroenterol. 2018 Oct 3;18(1):145. doi: 10.1186/s12876-018-0872-1.
This study aimed to quantify the effects of aging and urbanization on major gastrointestinal disease (liver cirrhosis, hepatitis B, diarrhea, liver cancer, stomach cancer, pancreas cancer, hepatitis C, esophagus cancer, colon/rectum cancer, gastrointestinal ulcers, diabetes, and appendicitis).
We accessed 2004 and 2011 mortality statistics from the most developed cities and least developed rural areas in China using a retrospective design. The relative risk of death associated with urbanization and age was quantified using Generalized linear model (the exp.(B) from model is interpreted as the risk ratio; the greater the B, the greater the impact of urbanized factors or aging factor or effect of aging factor with urbanization). The interaction between region (cities and rural areas) and age was considered as indicator to assess role of age in mortality with urbanization.
Greater risk of disease with urbanization were, in ascending order, for diabetes, colon/rectum cancer, hepatitis C and pancreas cancer. Stronger the effect of aging with urbanization were, in ascending order, for stomach cancer, ulcer, liver cancer, colon/rectum cancer, pancreas cancer, diabetes, hepatitis C, appendicitis and diarrhea. When the effects of aging and urbanization on diseases were taken together as the dividing value, we were able to further divide the 12 gastrointestinal diseases into three groups to guide the development of medical strategies.
It was suggested that mortality rate for most gastrointestinal diseases was sensitive to urbanization and control of external risk factors could lead to the conversion of most gastrointestinal disease.
本研究旨在量化老龄化和城市化对主要胃肠道疾病（肝硬化、乙型肝炎、腹泻、肝癌、胃癌、胰腺癌、丙型肝炎、食管癌、结肠/直肠癌、胃肠道溃疡、糖尿病和阑尾炎）的影响。
我们采用回顾性设计，获取了中国最发达城市和最不发达农村地区2004年和2011年的死亡率统计数据。使用广义线性模型量化与城市化和年龄相关的死亡相对风险（模型中的exp.(B)被解释为风险比；B越大，城市化因素或老龄化因素或老龄化因素与城市化的影响就越大）。将地区（城市和农村）与年龄之间的相互作用作为评估年龄在城市化死亡率中作用的指标。
随着城市化进程，疾病风险增加的顺序依次为糖尿病、结肠/直肠癌、丙型肝炎和胰腺癌。随着城市化，老龄化影响增强的顺序依次为胃癌、溃疡、肝癌、结肠/直肠癌、胰腺癌、糖尿病、丙型肝炎、阑尾炎和腹泻。当将老龄化和城市化对疾病的影响综合作为划分值时，我们能够将这12种胃肠道疾病进一步分为三组，以指导医疗策略的制定。
研究表明，大多数胃肠道疾病的死亡率对城市化敏感，控制外部风险因素可导致大多数胃肠道疾病的转变。
