Lee Su Jung, Cartmell Kathleen B
Research Institute on Nursing Science, School of Nursing, Hallym University, 1 Hallymdaehak-gil, Chuncheon-si 24252, Korea.
Department of Public Health Sciences, Clemson University, 519 Edwards Hall, Alpha Epsilon Drive, Clemson, SC 29634, USA.
J Pers Med. 2021 May 2;11(5):366. doi: 10.3390/jpm11050366.
We aimed to assess which lifestyle risk behaviors have the greatest influence on the risk of cardiovascular disease in cancer survivors and which of these behaviors are most prominently clustered in cancer survivors, using logistic regression and association rule mining (ARM). We analyzed a consecutive series of 897 cancer survivors from the Korean National Health and Nutritional Exam Survey (2012-2016). Cardiovascular disease risks were assessed using the atherosclerotic cardiovascular disease score (ASCVDs). We classified participants as being in a low-risk group if their calculated ASCVDs was less than 10% and as being in a high-risk group if their score was 10% or higher. We used association rule mining to analyze patterns of lifestyle risk behaviors by ASCVDs risk group, based upon public health recommendations described in the Alameda 7 health behaviors (current smoking, heavy drinking, physical inactivity, obesity, breakfast skipping, frequent snacking, and suboptimal sleep duration). Forty-two percent of cancer survivors had a high ASCVD. Current smoking (common odds ratio, 11.19; 95% confidence interval, 3.66-34.20, < 0.001) and obesity (common odds ratio, 2.67; 95% confidence interval, 1.40-5.08, < 0.001) were significant predictors of high ASCVD in cancer survivors within a multivariate model. In ARM analysis, current smoking and obesity were identified as important lifestyle risk behaviors in cancer survivors. In addition, various lifestyle risk behaviors co-occurred with smoking in male cancer survivors.
我们旨在通过逻辑回归和关联规则挖掘（ARM）来评估哪些生活方式风险行为对癌症幸存者患心血管疾病的风险影响最大，以及这些行为中哪些在癌症幸存者中最为显著地聚集。我们分析了韩国国家健康与营养检查调查（2012 - 2016年）中连续的897名癌症幸存者。使用动脉粥样硬化性心血管疾病评分（ASCVDs）评估心血管疾病风险。如果计算出的ASCVDs小于10%，我们将参与者分类为低风险组；如果评分达到10%或更高，则分类为高风险组。我们根据阿拉米达7项健康行为（当前吸烟、大量饮酒、缺乏身体活动、肥胖、不吃早餐、频繁吃零食和睡眠时长不足）中描述的公共卫生建议，使用关联规则挖掘来分析ASCVDs风险组的生活方式风险行为模式。42%的癌症幸存者有高ASCVD。在多变量模型中，当前吸烟（共同比值比，11.19；95%置信区间，3.66 - 34.20，<0.001）和肥胖（共同比值比，2.67；95%置信区间，1.40 - 5.08，<0.001）是癌症幸存者高ASCVD的显著预测因素。在ARM分析中，当前吸烟和肥胖被确定为癌症幸存者重要的生活方式风险行为。此外，在男性癌症幸存者中，各种生活方式风险行为与吸烟同时出现。
