Shen Yifei, Tian Wenqi, Li Na, Niu Yuhong
Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, China.
Shanghai Health Statistics Center, Shanghai, China.
Front Public Health. 2025 Mar 10;13:1516215. doi: 10.3389/fpubh.2025.1516215. eCollection 2025.
The aging problem in Shanghai is rapidly increasing, leading to the development of chronic comorbidities in older adults. Studying the correlations within comorbidity patterns can assist in managing disease prevention and implicate early control.
This study was a cross-sectional analysis based on a large sample size of 3,779,756 medical records. A network analysis and community classification were performed to illustrate disease networks and the internal relationships within comorbidity patterns among older adults in Shanghai.
The network analysis and community classification were performed using the IsingFit and Fast-greedy community functions. Datasets, including disease codes and disease prevalence, were collected from medical records.
The top five prevalent diseases were hypertension (64.78%), chronic ischemic heart disease (39.06%), type 2 diabetes mellitus (24.97%), lipid metabolism disorders (21.79%), and gastritis (19.71%). The sampled population showed susceptibility to 11 comorbidities associated with hypertension, 9 with diabetes, 28 with ischemic heart disease, 26 with gastritis, and 2 with lipid metabolism disorders in male patients. Diseases such as lipid metabolism disorders, gastritis, fatty liver, polyps of the colon, osteoporosis, atherosclerosis, and heart failure exhibited strong centrality.
The most common comorbidity patterns were dominated by ischemic heart disease and gastritis, followed by a ternary pattern between hypertension, diabetes, and lipid metabolism disorders. Male patients were more likely to have comorbidities related to cardiovascular and sleep problems, while women were more likely to have comorbidities related to thyroid disease, inflammatory conditions, and hyperuricemia. It was suggested that healthcare professionals focus on monitoring relevant vital signs and mental health according to the specific comorbidity patterns in older adults with chronic diseases, to prevent the development of new or more severe comorbidities.
上海的老龄化问题迅速加剧，导致老年人慢性合并症的发展。研究合并症模式中的相关性有助于疾病预防管理并意味着早期控制。
本研究是基于3779756份病历的大样本进行的横断面分析。进行了网络分析和社区分类，以阐明上海老年人合并症模式中的疾病网络和内部关系。
使用IsingFit和Fast-greedy社区功能进行网络分析和社区分类。从病历中收集包括疾病编码和疾病患病率在内的数据集。
前五种常见疾病为高血压（64.78%）、慢性缺血性心脏病（39.06%）、2型糖尿病（24.97%）、脂质代谢紊乱（21.79%）和胃炎（19.71%）。抽样人群中，男性患者对11种与高血压相关的合并症、9种与糖尿病相关的合并症、28种与缺血性心脏病相关的合并症、26种与胃炎相关的合并症以及2种与脂质代谢紊乱相关的合并症易感。脂质代谢紊乱、胃炎、脂肪肝、结肠息肉、骨质疏松症、动脉粥样硬化和心力衰竭等疾病表现出较强的中心性。
最常见的合并症模式以缺血性心脏病和胃炎为主，其次是高血压、糖尿病和脂质代谢紊乱之间的三元模式。男性患者更易出现与心血管和睡眠问题相关的合并症，而女性更易出现与甲状腺疾病、炎症性疾病和高尿酸血症相关的合并症。建议医护人员根据慢性病老年人的具体合并症模式，重点监测相关生命体征和心理健康，以预防新的或更严重合并症的发生。
