Abstract
孙至佳,樊俊宁,余灿清,郭彧,卞铮,裴培,杜怀东,陈君石,陈铮鸣,吕筠,李立明.中国10个地区成年人共病流行特征分析[J].Chinese journal of Epidemiology,2021,42(5):755-762
中国10个地区成年人共病流行特征分析
Prevalence, patterns and long-term changes of multimorbidity in adults from 10 regions of China
Received:March 05, 2020  
DOI:10.3760/cma.j.cn112338-20200305-00259
KeyWord: 共病  患病率  人群分布  聚类分析  成年人
English Key Word: Multimorbidity  Prevalence  Population distribution  Cluster analysis  Adult
FundProject:国家自然科学基金(81941018);中国香港KadoorieCharitable基金
Author NameAffiliationE-mail
Sun Zhijia Department of Epidemiology and Biostatistics, School of Public Health, Peking University/Peking University Center for Public Health and Epidemic Preparedness & Response/Peking University Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100191, China  
Fan Junning Department of Epidemiology and Biostatistics, School of Public Health, Peking University/Peking University Center for Public Health and Epidemic Preparedness & Response/Peking University Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100191, China  
Yu Canqing Department of Epidemiology and Biostatistics, School of Public Health, Peking University/Peking University Center for Public Health and Epidemic Preparedness & Response/Peking University Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100191, China  
Guo Yu Chinese Academy of Medical Sciences, Beijing 100730, China  
Bian Zheng Chinese Academy of Medical Sciences, Beijing 100730, China  
Pei Pei Chinese Academy of Medical Sciences, Beijing 100730, China  
Du Huaidong Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health/Medical Research Council Population Health Research Unit, University of Oxford, Oxford OX3 7LF, UK  
Chen Junshi China National Center for Food Safety Risk Assessment, Beijing 100022, China  
Chen Zhengming Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health/Medical Research Council Population Health Research Unit, University of Oxford, Oxford OX3 7LF, UK  
Lyu Jun Department of Epidemiology and Biostatistics, School of Public Health, Peking University/Peking University Center for Public Health and Epidemic Preparedness & Response/Peking University Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100191, China lvjun@bjmu.edu.cn 
Li Liming Department of Epidemiology and Biostatistics, School of Public Health, Peking University/Peking University Center for Public Health and Epidemic Preparedness & Response/Peking University Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100191, China  
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Abstract:
      目的 描述中国成年人的共病流行情况及其长期变化,以及常见的共病模式。方法 本研究纳入参与中国慢性病前瞻性研究第二次重复调查的25 033人,利用研究对象参加2004-2008年基线调查和2013-2014年第二次重复调查时采集的信息进行分析。根据自报疾病史、现场体格检查及血液样本检测等信息定义了13种慢性病或健康问题,将共病定义为同时患有≥2种慢性病或健康问题。采用系统聚类分析法描述共病模式。结果 研究对象在基线调查时的年龄为(51.5±10.1)岁,第二次重复调查时为(59.5±10.2)岁。2次调查平均间隔时间(8.0±0.8)年,共病率由33.5%上升至58.1%,人均患病数由1.15个增加至1.82个,平均每5年增长0.42个患病数。年长者、城市人群、文化程度低者的共病率较高,且患病数量随年龄的增速更快。吸烟及过量饮酒者的患病数量随年龄增速也更快。该人群中最常见的共病组合为:超重肥胖、高血压、糖尿病、中风和冠心病。结论 我国成年人群共病率较高,且随年龄增长而增加。共病情况在不同地区、文化程度水平和不同生活方式人群中存在差异。
English Abstract:
      Objective To describe the prevalence of multimorbidity and its secular trend, and to explore the common patterns of multimorbidity in Chinese adults. Methods A total of 25 033 participants who attended the second resurvey of China Kadoorie Biobank (CKB) were included in the study. We used data collected both at baseline (2004-2008) and at resurvey (2013-2014). A total of 13 chronic conditions were included, defined by self-reported, physical examination, and blood sample testing. Multimorbidity was defined as co-existence of two or more chronic conditions. Patterns of multimorbidity were explored using hierarchical cluster analysis. Results The mean age of participants was (51.5±10.1) years at baseline and (59.5±10.2) years at second resurvey. The prevalence of multimorbidity increased from 33.5% to 58.1% over (8.0±0.8) years of follow-up. The average number of chronic conditions per person increased from 1.15 to 1.82 and all participants increased 0.42 conditions per 5 years on average. Participants who were older, less educated or lived in urban areas had a higher prevalence of multimorbidity and a higher increase in the number of chronic conditions. The increase in the number of chronic conditions was also higher among smokers and heavy alcohol drinkers. The most common multimorbidity pattern in the present population consisted of obesity, hypertension, diabetes, stroke, and heart disease. Conclusions The prevalence of multimorbidity in Chinese adults is increasing rapidly due to ageing population. Populations of different sociodemographic background and lifestyle habits may have different prevalence of multimorbidity and changes in rates over time.
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