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美国各地区域性多种慢性病的复杂模式及决定因素。

Complex patterns and determinants of regional multiple chronic conditions across the United States.

作者信息

Xu Yanqing, Yan Ming, Fu Cong, Xu Wei, Liu Yan, Li Yuchen

机构信息

School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, Hubei 430079, China.

Health Management Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China.

出版信息

PNAS Nexus. 2024 Nov 14;3(12):pgae513. doi: 10.1093/pnasnexus/pgae513. eCollection 2024 Dec.

Abstract

Noncommunicable chronic diseases (NCDs) are a rapidly growing global public health concern, posing substantial challenges to healthcare systems. The presence of multiple (≥2) chronic conditions (MCC) exacerbates these challenges. In this study, we constructed an integrated MCC network to comprehensively evaluate the impact of NCD prevalence and associated factors on MCC patterns. We identified four distinct MCC patterns, each with its unique set of associated risk factors. Firstly, we found that race, sedentary lifestyles, and smoking habits were significant contributors to the co-occurrence of diabetes, chronic kidney disease, and cancer. Secondly, smoking habits and mental health were identified as risk factors associated with the clusters of high cholesterol, hypertension, coronary heart disease, and arthritis. Furthermore, the comorbidity of chronic obstructive pulmonary disease and asthma was affected by socioeconomic status, smoking habits, and educational attainment, and a noteworthy reciprocal relationship existed between these two MCC combinations. Thirdly, the combination of asthma and obesity is associated with risk factors such as mental health, smoking habits, sedentary lifestyles, and binge drinking behaviors. Finally, the pattern of depression-stroke comorbidity was influenced by risk factors including mental health, age, and sleep duration. Our findings hold valuable implications for healthcare system optimization, offering a pathway to mitigate the escalating burden of NCDs. Additionally, they provide a foundation for scientific strategies aimed at the joint prevention and management of these complex conditions, ultimately enhancing public health and safety on a global scale.

摘要

非传染性慢性病(NCDs)是一个在全球范围内迅速增长的公共卫生问题,给医疗系统带来了巨大挑战。多种(≥2种)慢性病(MCC)的存在加剧了这些挑战。在本研究中,我们构建了一个综合的MCC网络,以全面评估非传染性疾病患病率及相关因素对MCC模式的影响。我们识别出四种不同的MCC模式,每种模式都有其独特的相关风险因素集。首先,我们发现种族、久坐不动的生活方式和吸烟习惯是糖尿病、慢性肾病和癌症共病的重要促成因素。其次,吸烟习惯和心理健康被确定为与高胆固醇、高血压、冠心病和关节炎集群相关的风险因素。此外,慢性阻塞性肺疾病和哮喘的合并症受社会经济地位、吸烟习惯和教育程度的影响,并且这两种MCC组合之间存在值得注意的相互关系。第三,哮喘和肥胖的组合与心理健康、吸烟习惯、久坐不动的生活方式和暴饮行为等风险因素相关。最后,抑郁 - 中风合并症模式受心理健康、年龄和睡眠时间等风险因素的影响。我们的研究结果对医疗系统优化具有重要意义,为减轻非传染性疾病不断升级的负担提供了一条途径。此外,它们为旨在联合预防和管理这些复杂病症的科学策略奠定了基础,最终在全球范围内提高公众健康和安全水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5949/11630010/45360bcef98e/pgae513f1.jpg

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