Moreno-Juste Aída, Poblador-Plou Beatriz, Laguna-Berna Clara, Cruces-Mateo Belén, Lenotti Elisa, Santos-Mejías Alejandro, Gimeno-Feliú Luis A, Gimeno-Miguel Antonio
EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, 50009 Zaragoza, Spain.
Illueca Primary Care Health Centre, Aragon Health Service (SALUD), 50250 Illueca, Spain.
J Clin Med. 2024 Nov 27;13(23):7198. doi: 10.3390/jcm13237198.
: Chronic liver disease (CLD) is highly relevant in clinical practice due to its increasing incidence and associated mortality. We aimed to exhaustively characterize the multimorbidity of patients with CLD. : This is a retrospective observational study of patients aged 18 years and older with a diagnosis of CLD in 2015 in the EpiChron Cohort (Spain). We analyzed the prevalence of comorbidities according to sex and age, conducted a logistic regression analysis with CLD as the independent variable and each of the comorbidities as dependent variables to obtain odds ratios (OR) adjusted for age and sex, and performed an exploratory factor analysis to identify the presence of multimorbidity patterns. : A total of 6836 adults had a diagnosis of CLD (mean age 61.6 years; 62.5% women), with an average of 13 co-existing chronic conditions. Arterial hypertension, lipid metabolism disorders, diabetes, obesity, and musculoskeletal diseases were the most frequent diseases. From the list of 110 chronic conditions analyzed, 75 were systematically associated with CLD, including (OR, 95% confidence interval) chronic pancreatitis (41.2, 33.5-50.6) and inherited metabolic disorders (14.9, 11.8-18.8). Three multimorbidity patterns were identified in both men and women, including cardiovascular, metabolic-geriatric, and mental-substance use, with some differences by sex. : Multimorbidity is the norm in patients with CLD. Our results reveal that a comprehensive and integral approach based on person-centered care, which should take into account their entire spectrum of multimorbidity, is necessary during the care of this type of patient in clinical practice.
慢性肝病（CLD）因其发病率不断上升及相关死亡率，在临床实践中具有高度相关性。我们旨在详尽描述CLD患者的共病情况。这是一项针对2015年在西班牙EpiChron队列中诊断为CLD的18岁及以上患者的回顾性观察研究。我们根据性别和年龄分析了共病的患病率，以CLD为自变量、每种共病为因变量进行逻辑回归分析，以获得经年龄和性别调整的比值比（OR），并进行探索性因素分析以确定共病模式的存在。共有6836名成年人被诊断为CLD（平均年龄61.6岁；62.5%为女性），平均有13种并存的慢性病。动脉高血压、脂质代谢紊乱、糖尿病、肥胖和肌肉骨骼疾病是最常见的疾病。在分析的110种慢性病列表中，75种与CLD系统性相关，包括（OR，95%置信区间）慢性胰腺炎（41.2，33.5 - 50.6）和遗传性代谢紊乱（14.9，11.8 - 18.8）。在男性和女性中均识别出三种共病模式，包括心血管、代谢 - 老年和精神 - 物质使用模式，且存在一些性别差异。共病在CLD患者中很常见。我们的结果表明，在临床实践中护理这类患者时，基于以患者为中心的全面综合方法，应考虑其共病的全貌，这是必要的。
