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中国西南地区患有心血管疾病连续症的老年人群中不断变化的多重疾病模式:一项纵向队列研究。

Evolving multimorbidity patterns among ageing adults with cardiovascular disease continuum in Southwest China: A longitudinal cohort study.

作者信息

Qi Xiaoya, Zhang Ziyue, Jia Meng, Zhang Yangping, Feng Shuang, Bai Ruixue, Wang Siyao, Mao Jinning, Su Shu

机构信息

Health Care Physical Examination Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Department of Epidemiology and Biostatistics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Int J Cardiol Cardiovasc Risk Prev. 2025 May 1;25:200417. doi: 10.1016/j.ijcrp.2025.200417. eCollection 2025 Jun.

Abstract

BACKGROUND

The progression of multimorbidity in Chinese ageing adults with cardiovascular diseases remains inadequately understood. This study investigates the longitudinal evolution of cardiovascular disease continuum (CVDC)-related multimorbidity patterns in this population.

METHODS

The observational study analyzed medical examination reports from individuals aged 65 and older who underwent regular physical examinations during January 1, 2010 to December 31, 2022 at the Second Affiliated Hospital of Chongqing Medical University. Multimorbidity patterns of CVDC were examined. The construction of the multimorbidity network was based on Spearman correlation analyses to visualize the evolution of gender differences. Odds ratios (ORs) for developing multimorbidity in CVDC in compared to non-CVDC were calculated. Survival analysis and multivariate cox proportional hazards regression were performed to estimate the cumulative probability and identify risk factors for multimorbidity.

RESULTS

A total of 10,052 eligible individuals with 1835 (18.26 %) diagnosed with CVDC at baseline were included. The strongest positive correlation was observed between CVDC and obesity related diseases during both the initial (r = 0.208, r = 0.244) and final (r = 0.312, r = 0.248) examinations. Survival analysis revealed that the cumulative probability of multimorbidity of metabolic diseases in hypertension, dyslipidemia and atherosclerosis had increased over time; the corresponding adjusted HRs (95 % CIs) were 1.322 (1.219, 1.433), 1.553 (1.413, 1.706), and 1.460 (1.361, 1.567), respectively. The increasing risks of CVDC-related multimorbidity were primarily attributable to salty dietary habit (AHR = 1.336, 95 % CI: 1.239, 1.411).

CONCLUSIONS

Multimorbidity patterns and disease networks associated with CVDC have become more complex over time, especially with metabolic diseases. A high-salty diet significantly increased the risk of CVDC-related multimorbidity.

摘要

背景

中国心血管疾病老年人群中多种疾病共存的进展情况仍未得到充分了解。本研究调查了该人群中与心血管疾病连续体(CVDC)相关的多种疾病共存模式的纵向演变。

方法

这项观察性研究分析了2010年1月1日至2022年12月31日期间在重庆医科大学附属第二医院接受定期体检的65岁及以上个体的体检报告。研究了CVDC的多种疾病共存模式。多种疾病共存网络的构建基于斯皮尔曼相关性分析,以直观呈现性别差异的演变。计算了CVDC患者与非CVDC患者发生多种疾病共存的比值比(OR)。进行生存分析和多变量考克斯比例风险回归,以估计累积概率并确定多种疾病共存的危险因素。

结果

共纳入10,052名符合条件的个体,其中1835名(18.26%)在基线时被诊断为CVDC。在初始(r = 0.208,r = 0.244)和最终(r = 0.312,r = 0.248)检查中,均观察到CVDC与肥胖相关疾病之间存在最强的正相关。生存分析显示,高血压、血脂异常和动脉粥样硬化中代谢性疾病多种疾病共存的累积概率随时间增加;相应的校正风险比(95%置信区间)分别为1.322(1.219,1.433)、1.553(1.413,1.706)和1.460(1.361,1.567)。CVDC相关多种疾病共存风险的增加主要归因于高盐饮食习惯(调整后风险比=1.336,95%置信区间:1.239,1.411)。

结论

随着时间的推移,与CVDC相关的多种疾病共存模式和疾病网络变得更加复杂,尤其是与代谢性疾病相关的情况。高盐饮食显著增加了CVDC相关多种疾病共存的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab11/12104718/03d4f626b80a/gr1.jpg

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