瑞典南部心力衰竭与血液系统恶性肿瘤和实体恶性肿瘤患病率的相关性：一项横断面研究。
Associations of heart failure to prevalence of haematologic- and solid malignancies in southern Sweden: A cross-sectional study.
机构信息
Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden.
出版信息
PLoS One. 2023 Oct 13;18(10):e0292853. doi: 10.1371/journal.pone.0292853. eCollection 2023.
BACKGROUND
Heart failure (HF) and cancer are common diseases among the elderly population. Many chronic diseases, including diabetes mellitus (DM), share risk factors and increase the incidence of HF and cancer. The aim of this study was to investigate if there was an association between HF and the prevalence of haematologic- and solid malignancies.
METHODS
The study population was comprised of almost one million adults living in southern Sweden in 2015. All participants were divided into seven age groups from 20 and onwards, and 10 percentiles according to their socioeconomic status (SES). All data concerning diagnoses from each consultation in both primary- and secondary health care were collected during 18 months. The prevalence of haematologic and solid malignancies was measured separately for men and women, age groups, SES and multimorbidity levels. Multivariable logistic regression was used to determine the associations between HF and the probability of having haematologic- and solid malignancies in more complex models including stratifying variables.
RESULTS
People with HF had a higher prevalence of haematologic- and solid malignancies than the general population, but a lower prevalence of solid malignancies than the multimorbid population. The people with HF had an increased OR for haematologic malignancies, 1.69 (95% CI 1.51-1.90), and solid malignancies, OR 1.21 (95% CI 1.16-1.26), when adjusted for gender and age. In more complex multivariate models, multimorbidity explained the increased OR for haematologic- and solid malignancies in people with HF. Increasing socioeconomic deprivation was associated with a decreased risk for solid malignancies, with the lowest risk in the most socioeconomically deprived CNI-percentile.
CONCLUSIONS
HF was shown to be associated with malignancies, especially haematologic malignancies. Multimorbidity, however, was an even more important factor for both haematologic- and solid malignancies than HF in our study, but not socioeconomic deprivation. Further research on the interactions between the chronic conditions in people with HF is warranted to examine the strength of association between HF and malignancies.
背景
心力衰竭（HF）和癌症是老年人群中的常见疾病。许多慢性疾病，包括糖尿病（DM），具有共同的危险因素，增加了 HF 和癌症的发病率。本研究的目的是探讨 HF 是否与血液系统恶性肿瘤和实体恶性肿瘤的患病率有关。
方法
研究人群由 2015 年居住在瑞典南部的近 100 万成年人组成。所有参与者根据年龄分为 20 岁及以上的七个年龄组，并根据社会经济地位（SES）分为 10 个百分位组。在 18 个月期间，收集了所有来自初级和二级保健的每次就诊的诊断数据。男性和女性、年龄组、SES 和多种合并症水平分别测量血液系统和实体恶性肿瘤的患病率。使用多变量逻辑回归确定 HF 与血液系统和实体恶性肿瘤的概率之间的关联，在更复杂的模型中包括分层变量。
结果
HF 患者的血液系统和实体恶性肿瘤患病率高于一般人群，但实体恶性肿瘤患病率低于多种合并症人群。HF 患者血液系统恶性肿瘤的 OR 为 1.69（95%CI 1.51-1.90），实体恶性肿瘤的 OR 为 1.21（95%CI 1.16-1.26），在调整性别和年龄后。在更复杂的多变量模型中，多种合并症解释了 HF 患者血液系统和实体恶性肿瘤的增加 OR。社会经济剥夺程度的增加与实体恶性肿瘤的风险降低相关，在最社会经济上被剥夺的 CNI 百分位中风险最低。
结论
HF 与恶性肿瘤相关，尤其是血液系统恶性肿瘤。然而，在我们的研究中，多种合并症是血液系统和实体恶性肿瘤的重要因素，比 HF 更为重要，但不是社会经济剥夺。需要进一步研究 HF 患者慢性疾病之间的相互作用，以检查 HF 与恶性肿瘤之间的关联强度。
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