Multimorbidity of four cardiometabolic and chronic pulmonary disease groups: prevalence and attributable fraction in US adults, 2007-2012.
Multimorbidity of four cardiometabolic and chronic pulmonary disease groups: prevalence and attributable fraction in US adults, 2007-2012.
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DOI：
10.15256/joc.2017.7.89
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发表时间：
2017-01-01
影响因子：
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通讯作者：
Saydah, Sharon H
中科院分区：
文献类型：
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作者：
Staimez, Lisa R;Wei, Melissa Y;Saydah, Sharon H
背景技术背景：心脏代谢性疾病和慢性肺部疾病可能与可改变的风险因素相关，这些风险因素可以有针对性地预防多发性硬化症。方法：（i）估计四个心脏代谢性疾病和慢性肺部疾病组的多发性硬化症患病率;（ii）将多发性硬化症的患病率与一种疾病和无疾病的患病率进行比较;（iii）量化多发性硬化症可改变的风险因素的人群归因分数（PAF）。设计：检查了参加2007-2012年美国国家健康和营养检查调查的18-79岁成年人的数据。多发病定义为4个常见心脏代谢疾病和慢性肺病组中≥2种并存疾病。贫困，肥胖，吸烟，高血压和低高密度脂蛋白（HDL）cholesterolease.RESULTS：在16,676名成年人中，年龄标准化患病率为9.3%。随着年龄的增长，多发性骨髓瘤的发生率更高，18-39岁、40-54岁、55-64岁和65-79岁的成年人分别为1.5%至5.9%、15.0%和34.8%。最贫穷的成年人与非最贫穷的成年人之间以及黑人与其他种族/族裔之间的多重死亡率最高。肥胖、高血压和低HDL胆固醇的成年人中，多Mortocell也更高。具有最大PAF的危险因素是高血压（38.8%; 95%置信区间[CI] 29.4-47.4）和肥胖（19.3%; 95% CI 10.2-28.2）。结论：在美国，9.3%的成年人在四个慢性疾病组中患有多项疾病，老年人、黑人和贫困成年人的负担不成比例。我们的研究结果表明，针对两个中间可改变的危险因素，高血压和肥胖，可能有助于降低美国成年人的多发病率。
BACKGROUND: Cardiometabolic and chronic pulmonary diseases may be associated with modifiable risk factors that can be targeted to prevent multimorbidity.OBJECTIVES: (i) Estimate the prevalence of multimorbidity across four cardiometabolic and chronic pulmonary disease groups; (ii) compare the prevalence of multimorbidity to that of one disease and no disease; and (iii) quantify population attributable fractions (PAFs) for modifiable risk factors of multimorbidity.DESIGN: Data from adults aged 18-79 years who participated in the US National Health and Nutrition Examination Survey 2007-2012 were examined. Multimorbidity was defined as ≥2 co-occurring diseases across four common cardiometabolic and chronic pulmonary disease groups. Multivariate-adjusted PAFs for poverty, obesity, smoking, hypertension, and low high-density lipoprotein (HDL) cholesterol were estimated.RESULTS: Among 16,676 adults, the age-standardized prevalence of multimorbidity was 9.3%. The occurrence of multimorbidity was greater with age, from 1.5% to 5.9%, 15.0% and 34.8% for adults aged 18-39, 40-54, 55-64 and 65-79 years, respectively. Multimorbidity was greatest among the poorest versus non-poorest adults and among blacks versus other races/ethnicities. Multimorbidity was also greater in adults with obesity, hypertension, and low HDL cholesterol. Risk factors with greatest PAFs were hypertension (38.8%; 95% confidence interval [CI] 29.4-47.4) and obesity (19.3%; 95% CI 10.2-28.2).CONCLUSIONS: In the USA, 9.3% of adults have multimorbidity across four chronic disease groups, with a disproportionate burden among older, black, and poor adults. Our results suggest that targeting two intermediate modifiable risk factors, hypertension and obesity, might help to reduce the prevalence of multimorbidity in US adults.