Zhao Yang, Zhang Huan, Liu Xiaoyun, Desloge Allissa, Wang Qian, Zhao Siqi, Song Lili, Tzoulaki Ioanna
The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
The George Institute for Global Health, Beijing, China.
Front Cardiovasc Med. 2023 Feb 9;10:922932. doi: 10.3389/fcvm.2023.922932. eCollection 2023.
In China, a limited number of studies focus on women and examine the effect of cardiometabolic multimorbidity (defined as the presence of two or more cardiometabolic diseases) on health outcomes. This research aims to investigate the epidemiology of cardiometabolic multimorbidity and the association of cardiometabolic multimorbidity with long-term mortality.
This study used data from the China Health and Retirement Longitudinal Study between 2011 and 2018, which includes 4,832 women aged 45 years and older in China. Poisson-distributed Generalized Linear Models (GLM) were applied to examine the association of cardiometabolic multimorbidity with all-cause mortality.
Overall, the prevalence of cardiometabolic multimorbidity was 33.1% among the total sample of 4,832 Chinese women, and increased with age, ranging from 28.5% (22.1%) for those aged 45-54 years to 65.3% (38.2%) for those aged ≥75 years in urban (rural) areas. Compared with the group of none and single disease, cardiometabolic multimorbidity was positively associated with all-cause death (RR = 1.509, 95% CI = 1.130, 2.017), after adjusting socio-demographic and lifestyle behavioral covariates. Stratified analyses revealed that the association between cardiometabolic multimorbidity and all-cause death was only statistically significant (RR = 1.473, 95% CI = 1.040, 2.087) in rural residents, but not significant in urban residents.
Cardiometabolic multimorbidity is common among women in China and has been associated with excess mortality. Targeted strategies and people-centered integrated primary care models must be considered to more effectively manage the cardiometabolic multimorbidity shift from focusing on single-disease.
在中国，仅有少数研究聚焦于女性，并探讨心血管代谢性多种疾病（定义为存在两种或更多种心血管代谢性疾病）对健康结局的影响。本研究旨在调查心血管代谢性多种疾病的流行病学情况以及心血管代谢性多种疾病与长期死亡率之间的关联。
本研究使用了中国健康与养老追踪调查2011年至2018年的数据，该调查涵盖了中国4832名45岁及以上的女性。采用泊松分布广义线性模型（GLM）来检验心血管代谢性多种疾病与全因死亡率之间的关联。
总体而言，在4832名中国女性的总样本中，心血管代谢性多种疾病的患病率为33.1%，且随年龄增长而升高，城市（农村）地区45 - 54岁人群的患病率为28.5%（22.1%），≥75岁人群的患病率为65.3%（38.2%）。在调整社会人口学和生活方式行为协变量后，与无疾病和单一疾病组相比，心血管代谢性多种疾病与全因死亡呈正相关（RR = 1.509，95%CI = 1.130，2.017）。分层分析显示，心血管代谢性多种疾病与全因死亡之间的关联仅在农村居民中具有统计学意义（RR = 1.473，95%CI = 1.040，2.087），而在城市居民中不显著。
心血管代谢性多种疾病在中国女性中很常见，并与额外死亡率相关。必须考虑有针对性的策略和以患者为中心的综合初级保健模式，以便更有效地管理心血管代谢性多种疾病，从专注于单一疾病的模式转变过来。
