Sanjari Elaheh, Ahmadi Ali, Raeisi Shahraki Hadi
Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Iran J Med Sci. 2024 Nov 1;49(11):699-706. doi: 10.30476/ijms.2023.100513.3275. eCollection 2024 Nov.
During the last decades, the role of economic status and wealth-related variables in relation to the mortality and incidence of a wide range of diseases have received increased attention. This study focused on clustering the economic status of a population-based study using partitioning around the medoid (PAM) and then investigating the association between the obtained economic clusters and the incidence of non-communicable diseases (NCDs).
The present study was based on data from Shahrekord Cohort Study (SCS). This study considered nine NCDs, including cardiac disease, myocardial infarction, diabetes, hypertension, stroke, all types of malignancies, chronic lung disease, depression, and obesity, among 7034 participants aged 35 and 70 from the urban population of Sharekord (IRAN) in 2022. Four quantitative and four qualitative variables were used to cluster the economic status. The package was used to determine the optimal number of clusters, and the K-med package in R software (version 4.2.1) was used for PAM clustering. Descriptive statistics were reported as frequency (%) or median (IQR), and statistical analysis was performed using the Chi square test and Mann-Whitney test in SPSS software (version 19.0). P<0.05 was considered statistically significant.
The estimated optimal number of clusters was two. The first cluster contained individuals with good economic status, while the second cluster contained those with a moderate economic status. The findings indicated that individuals with a good economic status had significantly higher rates of cardiac disease (7.2% versus 5.3%, P<0.001), stroke (1.3% versus 0.6%, P<0.001), diabetes (12.8% versus 9.1%, P<0.001), hypertension (21.6% versus 15.6%, P<0.001), depression (P<0.001), and obesity (P=0.03).
The findings of the present study showed that economic status was significantly associated with the majority of NCDs.
在过去几十年中，经济状况和与财富相关的变量在多种疾病的死亡率和发病率方面所起的作用受到了更多关注。本研究聚焦于使用围绕中心点的划分法（PAM）对一项基于人群的研究中的经济状况进行聚类，然后调查所获得的经济集群与非传染性疾病（NCDs）发病率之间的关联。
本研究基于设拉子队列研究（SCS）的数据。该研究在2022年对设拉子（伊朗）城市地区7034名年龄在35至70岁的参与者进行了调查，考虑了九种非传染性疾病，包括心脏病、心肌梗死、糖尿病、高血压、中风、各类恶性肿瘤、慢性肺病、抑郁症和肥胖症。使用四个定量变量和四个定性变量对经济状况进行聚类。使用该软件包确定最佳聚类数，并在R软件（版本4.2.1）中使用K-med软件包进行PAM聚类。描述性统计以频率（%）或中位数（IQR）表示，统计分析在SPSS软件（版本19.0）中使用卡方检验和曼-惠特尼检验进行。P<0.05被认为具有统计学意义。
估计的最佳聚类数为两个。第一组包含经济状况良好的个体，而第二组包含经济状况中等的个体。研究结果表明，经济状况良好的个体患心脏病（7.2%对5.3%，P<0.001）、中风（1.3%对0.6%，P<0.001）、糖尿病（12.8%对9.1%，P<0.001）、高血压（21.6%对15.6%，P<0.001）、抑郁症（P<0.001）和肥胖症（P=0.03）的比率显著更高。
本研究结果表明，经济状况与大多数非传染性疾病显著相关。
