Xie Na, Xiong Huali, Jiang Xin
Chongqing General Hospital, Chongqing, China.
Center for Mental Health of Rongchang District, Chongqing, China.
Front Med (Lausanne). 2025 Aug 21;12:1609831. doi: 10.3389/fmed.2025.1609831. eCollection 2025.
The prevalence, patterns, and impact of multimorbidity on health-related quality of life (HRQoL) remain inadequately understood among rural populations in southwest China. This study seeks to fill this knowledge gap by systematically examining these aspects.
Participants were recruited from the China Multi-Ethnic Cohort (CMEC) study. Incident cases of 13 chronic conditions were documented. Multimorbidity was defined as the presence of two or more chronic conditions in an individual. Principal component factor analysis (PCFA) was performed to identify patterns of multimorbidity. Tobit regression analysis and restricted cubic spline were employed to assess the correlation between multimorbidity patterns and HRQoL.
A total of 2,998 participants were enrolled, with a mean age of 50.65 years (SD = 11.99). The prevalence of multimorbidity was 48.50%. Four multimorbidity patterns were identified by PCFA: circulatory system pattern, digestive system pattern, metabolic syndrome pattern, and hepatobiliary system pattern. All four patterns were negatively correlated with HRQoL, as demonstrated by tobit regression analysis ( = -0.024, = -0.020, = -0.007, = -0.018; all < 0.001). Restricted cubic spline also demonstrated the negative correlation between different multimorbidity patterns and HRQoL, after adjusting for potential confounding factors. Subgroup analysis in different gender, age, and average yearly family total income also demonstrated these negative correlations.
The prevalence of multimorbidity is relatively high in rural southwest China. Distinct multimorbidity patterns were correlated with poorer HRQoL. These findings enhance the understanding of multimorbidity patterns and may inform the development of tailored primary healthcare services.
在中国西南部农村人口中，对多种慢性病共存的患病率、模式及其对健康相关生活质量（HRQoL）的影响仍了解不足。本研究旨在通过系统检查这些方面来填补这一知识空白。
参与者来自中国多民族队列（CMEC）研究。记录了13种慢性病的发病情况。多种慢性病共存被定义为个体存在两种或更多种慢性病。进行主成分因子分析（PCFA）以确定多种慢性病共存的模式。采用 Tobit 回归分析和受限立方样条来评估多种慢性病共存模式与健康相关生活质量之间的相关性。
共纳入2998名参与者，平均年龄为50.65岁（标准差=11.99）。多种慢性病共存的患病率为48.50%。通过主成分因子分析确定了四种多种慢性病共存模式：循环系统模式、消化系统模式、代谢综合征模式和肝胆系统模式。Tobit回归分析表明，所有这四种模式均与健康相关生活质量呈负相关（β=-0.024，β=-0.020，β=-0.007，β=-0.018；均P<0.001）。在调整潜在混杂因素后，受限立方样条也显示出不同的多种慢性病共存模式与健康相关生活质量之间的负相关。在不同性别、年龄和家庭年均总收入的亚组分析中也显示出这些负相关。
中国西南部农村地区多种慢性病共存的患病率相对较高。不同的多种慢性病共存模式与较差的健康相关生活质量相关。这些发现增进了对多种慢性病共存模式的理解，并可能为制定针对性的初级医疗服务提供参考。
